Healthcare Provider Details

I. General information

NPI: 1053346056
Provider Name (Legal Business Name): JEANNE W BISSONNETTE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 PLEASANT ST
NEW BEDFORD MA
02740
US

IV. Provider business mailing address

26 HERRING BROOK LANE
ROCHESTER MA
02770
US

V. Phone/Fax

Practice location:
  • Phone: 508-996-8572
  • Fax: 508-991-8618
Mailing address:
  • Phone: 508-763-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number2032464
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: