Individual
JESSICA TRASK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 521-2200
Mailing address
200 FRUIT ST, MANSFIELD, MA 02048-3115
(508) 250-1447
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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