Provider Demographics
NPI:1770041261
Name:TAKAHASHI, JEANNE
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:TAKAHASHI
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 1:16 SPOONER ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4451
Mailing Address - Country:US
Mailing Address - Phone:508-933-4013
Mailing Address - Fax:
Practice Address - Street 1:16 SPOONER ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4451
Practice Address - Country:US
Practice Address - Phone:508-933-4013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management