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General NPI Number Information
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NPI Number | 1326682873
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Entity Type | Organization
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Legal Business Name | SAJ CONSULTATION LLC
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 552 MASSACHUSETTS AVE STE 202
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City | CAMBRIDGE
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State | MA
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Zip | 02139-4088
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Country | US
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Telephone | 617-852-7615
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Fax | 617-812-5894
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Provider Business Mailing Address
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Address Line | 12 GILSON AVE
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City | MEDFORD
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State | MA
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Zip | 02155-1815
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Country | US
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Telephone | 617-852-7615
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Fax | 617-812-5894
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHEILA JEWETT
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Credential | MSW,LICSW
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Telephone | 617-852-7615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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