Provider Demographics
NPI:1073822763
Name:SALIE, JEANMARIE
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:
Last Name:SALIE
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 1:317 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-4302
Mailing Address - Country:US
Mailing Address - Phone:617-427-4470
Mailing Address - Fax:617-442-9419
Practice Address - Street 1:317 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-4302
Practice Address - Country:US
Practice Address - Phone:617-427-4470
Practice Address - Fax:617-442-9419
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor