Provider Demographics
NPI:1558070557
Name:TORRES, JANGELY
Entity Type:Individual
Prefix:
First Name:JANGELY
Middle Name:
Last Name:TORRES
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 1:318 MAIN ST STE 190
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-3612
Mailing Address - Country:US
Mailing Address - Phone:508-936-7174
Mailing Address - Fax:
Practice Address - Street 1:318 MAIN ST STE 190
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-3612
Practice Address - Country:US
Practice Address - Phone:508-936-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician