Provider Demographics
NPI:1114291531
Name:PREDMORE, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PREDMORE
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 1:3 CALVIN COOMBS RD
Mailing Address - Street 2:
Mailing Address - City:COLRAIN
Mailing Address - State:MA
Mailing Address - Zip Code:01340-9705
Mailing Address - Country:US
Mailing Address - Phone:413-774-1000
Mailing Address - Fax:
Practice Address - Street 1:1 ARCH PL
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2457
Practice Address - Country:US
Practice Address - Phone:413-774-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor