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General NPI Number Information
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NPI Number | 1053963892
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Entity Type | Individual
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Provider Name | JESSICA NAZARENO FERRER LMT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 35 BEDFORD ST STE 11
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City | LEXINGTON
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State | MA
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Zip | 02420-4439
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Country | US
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Telephone | 339-368-6669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7043
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City | MILFORD
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State | NH
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Zip | 03055-7043
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Country | US
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Telephone | 339-368-6669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-4148
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License Number State | MA
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