Provider Demographics
NPI:1316140080
Name:ZEHR, JEREMY LYN
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:LYN
Last Name:ZEHR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 CENTRAL AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3662
Mailing Address - Country:US
Mailing Address - Phone:727-492-2693
Mailing Address - Fax:
Practice Address - Street 1:695 CENTRAL AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3662
Practice Address - Country:US
Practice Address - Phone:727-492-2693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7812103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical