Provider Demographics
NPI:1336672419
Name:DARBY, JEANNE PATRICIA
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:PATRICIA
Last Name:DARBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:DARBY
Other - Last Name:GOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:112 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1606
Mailing Address - Country:US
Mailing Address - Phone:781-626-0135
Mailing Address - Fax:
Practice Address - Street 1:112 NORTH ST
Practice Address - Street 2:
Practice Address - City:NORTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02191-1606
Practice Address - Country:US
Practice Address - Phone:781-626-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator