Provider Demographics
NPI:1821867995
Name:PATEL, JENSI
Entity Type:Individual
Prefix:
First Name:JENSI
Middle Name:
Last Name:PATEL
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 1:630 PRINCETON BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2232
Mailing Address - Country:US
Mailing Address - Phone:978-710-1719
Mailing Address - Fax:
Practice Address - Street 1:630 PRINCETON BLVD APT 3
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2232
Practice Address - Country:US
Practice Address - Phone:978-710-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician