Provider Demographics
NPI:1154690170
Name:SPRISSLER, JENNIFER CUSHING (CLMT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CUSHING
Last Name:SPRISSLER
Suffix:
Gender:F
Credentials:CLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 BEATTIE ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-2632
Mailing Address - Country:US
Mailing Address - Phone:774-319-4169
Mailing Address - Fax:
Practice Address - Street 1:344 BEATTIE ST
Practice Address - Street 2:UNIT 1
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-2632
Practice Address - Country:US
Practice Address - Phone:774-319-4169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMT01857225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist