Provider Demographics
NPI:1467705152
Name:WEST, JENNIFER (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE U-3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2707
Mailing Address - Country:US
Mailing Address - Phone:617-259-1895
Mailing Address - Fax:
Practice Address - Street 1:160 COMMONWEALTH AVE
Practice Address - Street 2:SUITE U-3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2707
Practice Address - Country:US
Practice Address - Phone:617-259-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist