Individual
DR. THEODORE JASNOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
31 LAKE ST, NORTH CENTRAL HUMAN SERVICES, GARDNER, MA 01440-3879
(978) 632-9400
(978) 632-6425
Mailing address
7 CEDAR ST, CLINTON, MA 01510-2206
(978) 365-2286
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1805
MA
103TC0700X
Clinical Psychologist
1805
MA
103TC2200X
Clinical Child & Adolescent Psychologist
1805
MA
103TP0814X
Psychoanalysis Psychologist
Primary
1805
MA
Other
Enumeration date
12/21/2006
Last updated
09/11/2025
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