Provider Demographics
NPI:1619140084
Name:CARRANCEJIE, JENNIFER L
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CARRANCEJIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:CAILLOUETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5153 N 9TH AVE
Mailing Address - Street 2:STE 305
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8785
Mailing Address - Country:US
Mailing Address - Phone:850-476-3131
Mailing Address - Fax:850-476-4848
Practice Address - Street 1:5153 N 9TH AVE
Practice Address - Street 2:STE 305
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8785
Practice Address - Country:US
Practice Address - Phone:850-476-3131
Practice Address - Fax:850-476-4848
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker