Provider Demographics
NPI:1093037525
Name:MARKOWITZ, JESSICA T (PHD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:T
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:TUTTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 JOSLIN PL
Mailing Address - Street 2:PEDIATRICS
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5306
Mailing Address - Country:US
Mailing Address - Phone:617-732-2603
Mailing Address - Fax:617-732-2451
Practice Address - Street 1:1 JOSLIN PL
Practice Address - Street 2:PEDIATRICS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5306
Practice Address - Country:US
Practice Address - Phone:617-732-2603
Practice Address - Fax:617-732-2451
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9152103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical