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Individual

JENNIFER I DESAULNIERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
111 OLD ROAD TO 9 ACRE COR, CONCORD, MA 01742-4141
(978) 369-1113
Mailing address
111 OLD ROAD TO 9 ACRE COR, CONCORD, MA 01742-4141
(978) 369-1113

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
611ADC91-A2CC-408B-9
MASS CANS
MA
Enumeration date
07/12/2012
Last updated
04/07/2014
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