Provider Demographics
NPI:1467138248
Name:GERMANO, JUSTINA RAE
Entity Type:Individual
Prefix:
First Name:JUSTINA
Middle Name:RAE
Last Name:GERMANO
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 1:146 BEACON ST.
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701
Mailing Address - Country:US
Mailing Address - Phone:508-431-0053
Mailing Address - Fax:866-430-5155
Practice Address - Street 1:146 BEACON ST.
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-431-0053
Practice Address - Fax:866-430-5155
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10000184103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst