Provider Demographics
NPI:1891297578
Name:MULLIN-SAUCEDO, JANET MARIE
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:MULLIN-SAUCEDO
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 1:14 FRESH WIND DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2720
Mailing Address - Country:US
Mailing Address - Phone:781-588-2409
Mailing Address - Fax:
Practice Address - Street 1:143 NEWBURY ST FL 4
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2925
Practice Address - Country:US
Practice Address - Phone:781-588-2409
Practice Address - Fax:781-588-2409
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10239251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical