Provider Demographics
NPI:1043537095
Name:GADSON LOUISSAINT, JANICE
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:
Last Name:GADSON LOUISSAINT
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 1:65 WESTLAND AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-4559
Mailing Address - Country:US
Mailing Address - Phone:617-320-4762
Mailing Address - Fax:
Practice Address - Street 1:65 WESTLAND AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-4559
Practice Address - Country:US
Practice Address - Phone:617-320-4762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator