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General NPI Number Information
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NPI Number | 1336564483
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Entity Type | Individual
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Provider Name | MS. JESSE BLUE GLASS BEGENYI
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Gender | Female
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Dates
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Enumeration Date | 02/26/2014
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Last Update Date | 07/02/2015
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Provider Practice Location Address
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Address Line | 540 VFW PARKWAY, STE 8 SUITE 8
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City | WEST ROXBURY
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State | MA
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Zip | 02132-1901
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Country | US
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Telephone | 617-325-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 394 CENTRE ST 2
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-1876
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Country | US
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Telephone | 240-676-1423
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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