Provider Demographics
NPI:1013647387
Name:JOBSON, DELLECHA
Entity Type:Individual
Prefix:
First Name:DELLECHA
Middle Name:
Last Name:JOBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LIBERTY SQ STE 2607
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-5800
Mailing Address - Country:US
Mailing Address - Phone:617-216-6201
Mailing Address - Fax:
Practice Address - Street 1:51 LILLIAN ST N
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2112
Practice Address - Country:US
Practice Address - Phone:617-216-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide