Doctor Name: | JESSICA M LEVY |
NPI Number: | 1013328152 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 231 Main St Suite 300 Brockton, MA - 023014342 |
Business Phone Number: | 5085862660 |
Business Fax Number: | 5084271505 |
Mailing Address: | 114 Main St, LAKEVILLE |
State: | MA |
Postal Code: | 023471612 |
Phone Number: | 7747667721 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2014 |
NPI Last Update Date: | 05/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |