Individual
MRS. JANE MARIE BOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
574 MAIN STREET, WEYMOUTH, MA 02190
(781) 331-2533
Mailing address
5008 SE MARINER VILLAGE LN, STUART, FL 34997-2151
(772) 463-7341
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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