Provider Demographics
NPI:1588911366
Name:BOYER, JENNIFER J
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:STRAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4854 AVENT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-4745
Mailing Address - Country:US
Mailing Address - Phone:904-405-6796
Mailing Address - Fax:
Practice Address - Street 1:4854 AVENT DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-4745
Practice Address - Country:US
Practice Address - Phone:904-405-6796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist