Provider Demographics
NPI:1023556628
Name:MCGEE, JENNIFER
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:MCGEE
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 1:12 JEPHERSON DR.
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-0200
Mailing Address - Country:US
Mailing Address - Phone:508-341-4435
Mailing Address - Fax:
Practice Address - Street 1:12 JEPHERSON DR
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:MA
Practice Address - Zip Code:01516-2572
Practice Address - Country:US
Practice Address - Phone:508-341-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1517-MH-B1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst