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General NPI Number Information
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NPI Number | 1134737240
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Entity Type | Individual
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Provider Name | JEANDRILIE FONT-LLORENS
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 440 MCCLELLAN HWY STE 105B
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City | BOSTON
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State | MA
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Zip | 02128-1101
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Country | US
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Telephone | 508-232-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 147 NORMAN ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-5003
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Country | US
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Telephone | 413-296-6181
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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