Provider Demographics
NPI:1336632413
Name:EUDY, KERRY JENNIFER (PHD, JD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:JENNIFER
Last Name:EUDY
Suffix:
Gender:F
Credentials:PHD, JD
Other - Prefix:DR
Other - First Name:KERRY
Other - Middle Name:JENNIFER
Other - Last Name:EUDY-HELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:110 TURNPIKE RD STE 308
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2863
Mailing Address - Country:US
Mailing Address - Phone:617-909-3101
Mailing Address - Fax:800-878-7017
Practice Address - Street 1:110 TURNPIKE RD STE 308
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2863
Practice Address - Country:US
Practice Address - Phone:617-909-3101
Practice Address - Fax:800-878-7017
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8926103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic