Provider Demographics
NPI:1487230652
Name:KERSAINT, REGINE KERSAINT
Entity Type:Individual
Prefix:
First Name:REGINE
Middle Name:KERSAINT
Last Name:KERSAINT
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 1:20 EASTBROOK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2088
Mailing Address - Country:US
Mailing Address - Phone:781-302-4600
Mailing Address - Fax:781-302-4635
Practice Address - Street 1:20 EASTBROOK RD STE 104
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2088
Practice Address - Country:US
Practice Address - Phone:781-302-4600
Practice Address - Fax:781-302-4635
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health