Provider Demographics
NPI:1699872176
Name:JEAN, CHRISTINE (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:JEAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 S DIXIE HWY # 196
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7919
Mailing Address - Country:US
Mailing Address - Phone:561-223-1727
Mailing Address - Fax:
Practice Address - Street 1:4591 E HIGHWAY 20 STE 202H
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8854
Practice Address - Country:US
Practice Address - Phone:561-223-1727
Practice Address - Fax:561-584-7551
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6942103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist