Provider Demographics
NPI:1003943622
Name:CABOUR, JANE LOISELLE (EDD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:LOISELLE
Last Name:CABOUR
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:LOISELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:462 BOSTON ST # 7
Mailing Address - Street 2:
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-1200
Mailing Address - Country:US
Mailing Address - Phone:978-322-0511
Mailing Address - Fax:
Practice Address - Street 1:462 BOSTON ST # 7
Practice Address - Street 2:
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-1200
Practice Address - Country:US
Practice Address - Phone:978-322-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4405103TA0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA253641OtherPACIFICARE
MA45707500OtherMAGELLAN BCBS
MA456445OtherTUFTS HEALTH PLAN
MA7545085OtherAETNA
MAW04431OtherBCBS
MA45707500OtherMAGELLAN BCBS