Provider Demographics
NPI:1740652783
Name:DELIO-GUIRAND, JESSICA (LADC1)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DELIO-GUIRAND
Suffix:
Gender:F
Credentials:LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CAMBRIDGEPARK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2392
Mailing Address - Country:US
Mailing Address - Phone:631-402-4700
Mailing Address - Fax:
Practice Address - Street 1:125 CAMBRIDGEPARK DR STE 301
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2392
Practice Address - Country:US
Practice Address - Phone:631-402-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)