Most Relevant Information
Provider Data
| NPI Number: | 1003504382 |
| Provider Name: | JACQUELYN SUE FEDROW MSW, LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 150008293 |
Most Important Dates
| Enumeration Date: | 04/25/2023 |
| Last Updated: | 09/21/2023 |
Provider Practice Location
8900 SE 165TH MULBERRY LN
THE VILLAGES
FL
321625884
Practice Location Phone/Fax
| Phone: | 3526745000 |
| Fax: |
Provider Mailing Location
8900 SE 165TH MULBERRY LN
THE VILLAGES
FL
321625884
Provider Mailing Phone/Fax
| Phone: | 3526745000 |
| Fax: |