Provider Demographics
NPI:1912308081
Name:WASGATT, JESSICA (BS)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:WASGATT
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-1225
Mailing Address - Country:US
Mailing Address - Phone:860-519-4510
Mailing Address - Fax:
Practice Address - Street 1:11 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2213
Practice Address - Country:US
Practice Address - Phone:508-798-1900
Practice Address - Fax:508-798-1908
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health