Individual
JOVANICA CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 SOUTHAMPTON ST, BOSTON, MA 02118-2711
(617) 534-6167
(617) 419-1471
Mailing address
1010 MASSACHUSETTS AVE, BOSTON, MA 02118-2600
(617) 419-3408
(617) 534-2611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/02/2016
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