Provider Demographics
NPI:1033220413
Name:WILLIAMS, JENNIE CATHERINE (MA)
Entity Type:Individual
Prefix:MS
First Name:JENNIE
Middle Name:CATHERINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3643
Mailing Address - Country:US
Mailing Address - Phone:508-398-9305
Mailing Address - Fax:
Practice Address - Street 1:859 WILLARD ST
Practice Address - Street 2:ONE ADAMS PLACE
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7482
Practice Address - Country:US
Practice Address - Phone:617-774-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist