Provider Demographics
NPI:1417013590
Name:GARRETT, JAYNE L (PYS D)
Entity Type:Individual
Prefix:DR
First Name:JAYNE
Middle Name:L
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PYS D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CEDAR ST
Mailing Address - Street 2:PSYCHIATRY & FAMILY COUNSELING
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2134
Mailing Address - Country:US
Mailing Address - Phone:978-840-1100
Mailing Address - Fax:
Practice Address - Street 1:25 MOHAWK DR
Practice Address - Street 2:PSYCHIATRY & FAMILY COUNSELING
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3363
Practice Address - Country:US
Practice Address - Phone:978-840-1100
Practice Address - Fax:508-792-1514
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA371455101YS0200X
MA6478103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical