Healthcare Provider Details

I. General information

NPI: 1598689671
Provider Name (Legal Business Name): PAUL LANIEL JEAN-BAPTISTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BOSTON POST RD W STE 101
MARLBOROUGH MA
01752-4667
US

IV. Provider business mailing address

56 WILBUR ST
WORCESTER MA
01606-1065
US

V. Phone/Fax

Practice location:
  • Phone: 508-624-0304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: