Individual
JESSA MALATESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 CHESTNUT ST STE 2E, ANDOVER, MA 01810-3600
(978) 749-2700
Mailing address
290 MISHAWUM RD UNIT 4047, WOBURN, MA 01801-2275
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY5000240
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000008360046
—
PA
Enumeration date
08/15/2016
Last updated
04/02/2024
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