Provider Demographics
NPI:1942807110
Name:VULPIS, JENNY (CTRS)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:VULPIS
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:LYNN
Other - Last Name:EXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:940 BELMONT ST (BR 135)
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:774-826-1955
Mailing Address - Fax:
Practice Address - Street 1:940 BELMONT ST (BR 135)
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:774-826-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist