Healthcare Provider Details

I. General information

NPI: 1316854607
Provider Name (Legal Business Name): JESSE PERRIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S MAIN ST STE 10
FALL RIVER MA
02721-5349
US

IV. Provider business mailing address

99 S MAIN ST STE 10
FALL RIVER MA
02721-5349
US

V. Phone/Fax

Practice location:
  • Phone: 508-444-8938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLABA10002347
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: