Provider Demographics
NPI:1851624142
Name:JEAN-BAPTISTE, CHANTAL (MED)
Entity Type:Individual
Prefix:MRS
First Name:CHANTAL
Middle Name:
Last Name:JEAN-BAPTISTE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2424
Mailing Address - Country:US
Mailing Address - Phone:781-986-4800
Mailing Address - Fax:781-986-4801
Practice Address - Street 1:9 CANTON ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2424
Practice Address - Country:US
Practice Address - Phone:781-986-4800
Practice Address - Fax:781-986-4801
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health