Provider Demographics
NPI:1649220062
Name:MAYER ALBINO, JENNIFER (AUD CCC-A)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MAYER ALBINO
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 418
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-337-6860
Mailing Address - Fax:781-337-2013
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 418
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-337-6860
Practice Address - Fax:781-337-2013
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA646231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5103258Medicaid
MA5103258Medicaid