Provider Demographics
NPI:1023324605
Name:JAFFEE, CATHERINE TELLIDES (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:TELLIDES
Last Name:JAFFEE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:33 BEDFORD ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4319
Mailing Address - Country:US
Mailing Address - Phone:978-514-0960
Mailing Address - Fax:978-582-1434
Practice Address - Street 1:33 BEDFORD ST
Practice Address - Street 2:SUITE 11
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4319
Practice Address - Country:US
Practice Address - Phone:978-514-0960
Practice Address - Fax:978-582-1434
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical