Individual
JESSLANE FANTAUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
(617) 469-8612
(617) 469-8691
Mailing address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
(617) 469-8612
(617) 469-8691
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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