Provider Demographics
NPI:1831676501
Name:GOTTLER, JANET M (MSW)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:GOTTLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JEAN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-3203
Mailing Address - Country:US
Mailing Address - Phone:781-883-1179
Mailing Address - Fax:
Practice Address - Street 1:21 JEAN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-3203
Practice Address - Country:US
Practice Address - Phone:781-883-1179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1067781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical