Provider Demographics
NPI:1275253098
Name:JERMYN, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:JERMYN
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 1:18 BARCELONA AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1757
Mailing Address - Country:US
Mailing Address - Phone:978-210-3061
Mailing Address - Fax:
Practice Address - Street 1:360 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3750
Practice Address - Country:US
Practice Address - Phone:978-263-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health