Individual
JIMMY FOUCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 DUDLEY ST, BOSTON, MA 02119-2769
(617) 989-9459
(617) 445-2672
Mailing address
520 DUDLEY STREET, BOSTON, MA 02119
(617) 989-9459
(717) 445-2672
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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