Provider Demographics
NPI:1881090645
Name:BALDASSARI, BOBBI-JO
Entity type:Individual
Prefix:
First Name:BOBBI-JO
Middle Name:
Last Name:BALDASSARI
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 1:16 BAY RD
Mailing Address - Street 2:APT 1
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4810
Mailing Address - Country:US
Mailing Address - Phone:978-601-2270
Mailing Address - Fax:
Practice Address - Street 1:35 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5529
Practice Address - Country:US
Practice Address - Phone:978-542-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health