Individual
MARISE JEANTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Mailing address
950 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-4701
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2345689
MA
Other
Enumeration date
04/03/2025
Last updated
07/22/2025
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