Individual
JADE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 CONSTITUTION WAY STE C, WOBURN, MA 01801-1199
(888) 754-0398
Mailing address
31 ADAMS ST UNIT 2, WALTHAM, MA 02453-4403
(413) 834-3839
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA3030173
DRIVERS LICENCE
MA
Enumeration date
11/11/2022
Last updated
11/11/2022
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