Healthcare Provider Details

I. General information

NPI: 1285180950
Provider Name (Legal Business Name): JESSICA LOUISSAINT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 MAIN ST STE 33A
MEDFIELD MA
02052-2099
US

IV. Provider business mailing address

266 MAIN ST STE 33A
MEDFIELD MA
02052-2099
US

V. Phone/Fax

Practice location:
  • Phone: 781-551-0999
  • Fax:
Mailing address:
  • Phone: 781-551-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: