Provider Demographics
NPI:1225278666
Name:SHAHEED, JAMAAL K (BS)
Entity Type:Individual
Prefix:MR
First Name:JAMAAL
Middle Name:K
Last Name:SHAHEED
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 SAINT MARKS RD
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2623
Mailing Address - Country:US
Mailing Address - Phone:617-506-0715
Mailing Address - Fax:
Practice Address - Street 1:59 SAINT MARKS RD
Practice Address - Street 2:
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2623
Practice Address - Country:US
Practice Address - Phone:617-506-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst