Provider Demographics
NPI:1740955228
Name:JEFFS, DAILIE M
Entity type:Individual
Prefix:
First Name:DAILIE
Middle Name:M
Last Name:JEFFS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 NONANTUM ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2413
Mailing Address - Country:US
Mailing Address - Phone:309-229-6006
Mailing Address - Fax:
Practice Address - Street 1:127 NONANTUM ST APT 1
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2413
Practice Address - Country:US
Practice Address - Phone:309-229-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health