Healthcare Provider Details

I. General information

NPI: 1962316075
Provider Name (Legal Business Name): JACQUELYN POISSANT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 DOGWOOD RD N
HUBBARDSTON MA
01452-1607
US

IV. Provider business mailing address

54 DOGWOOD RD N
HUBBARDSTON MA
01452-1607
US

V. Phone/Fax

Practice location:
  • Phone: 774-696-9247
  • Fax:
Mailing address:
  • Phone: 774-696-9247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18807-MT-MT
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: