Provider Demographics
NPI:1073988382
Name:JONAS, JESSICA (MS, L CGC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:JONAS
Suffix:
Gender:F
Credentials:MS, L CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST
Mailing Address - Street 2:BOX 851
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1552
Mailing Address - Country:US
Mailing Address - Phone:617-636-4277
Mailing Address - Fax:617-636-4325
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:BOX 851
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-4277
Practice Address - Fax:617-636-4325
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAGC043170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS