Provider Demographics
NPI:1114383486
Name:MARGOLIN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MARGOLIN
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 1:184 W MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1243
Mailing Address - Country:US
Mailing Address - Phone:508-622-5133
Mailing Address - Fax:
Practice Address - Street 1:184 W MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1243
Practice Address - Country:US
Practice Address - Phone:508-622-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-02
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health