Provider Demographics
NPI:1891846622
Name:DURHAM, JENNIFER M (MA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:DURHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HOLLIS ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8615
Mailing Address - Country:US
Mailing Address - Phone:508-935-0769
Mailing Address - Fax:508-661-0232
Practice Address - Street 1:27 HOLLIS ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8615
Practice Address - Country:US
Practice Address - Phone:508-935-0769
Practice Address - Fax:508-661-0232
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional