Healthcare Provider Details

I. General information

NPI: 1952265852
Provider Name (Legal Business Name): MS. JESSICA KAUHANE SIZANOSKI DE ARAUJO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 WILLARD ST
AYER MA
01432
US

IV. Provider business mailing address

183 WILLARD ST
AYER MA
01432
US

V. Phone/Fax

Practice location:
  • Phone: 978-654-3163
  • Fax:
Mailing address:
  • Phone: 978-654-3163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: