Provider Demographics
NPI:1588188544
Name:FORAN, JENNIFER (MSED)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:FORAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-2108
Mailing Address - Country:US
Mailing Address - Phone:508-481-1015
Mailing Address - Fax:
Practice Address - Street 1:33 TURNKPIKE ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772
Practice Address - Country:US
Practice Address - Phone:508-481-1015
Practice Address - Fax:508-481-1015
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician