Doctor Name: | JESSICA JARRARD |
NPI Number: | 1053789404 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 22 Pleasant St Malden, MA - 021485119 |
Business Phone Number: | 7818512648 |
Business Fax Number: | 7818512699 |
Mailing Address: | 22 Pleasant St, MALDEN |
State: | MA |
Postal Code: | 021485119 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/02/2015 |
NPI Last Update Date: | 09/02/2015 |
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: |