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General NPI Number Information
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NPI Number | 1407656309
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Entity Type | Organization
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Legal Business Name | JEUDEMONIA WELLNESS LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 622 CUMMINS HWY # B
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City | BOSTON
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State | MA
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Zip | 02126-1200
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Country | US
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Telephone | 617-921-6984
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Fax |
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Provider Business Mailing Address
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Address Line | 555 N MAIN ST # 14151A
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City | PROVIDENCE
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State | RI
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Zip | 02904-5722
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Country | US
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Telephone | 617-921-6984
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JHANEV ALLEN
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Credential | PSYD
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Telephone | 617-921-6984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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