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General NPI Number Information
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NPI Number | 1538780010
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Entity Type | Individual
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Provider Name | JACLYN ELIZABETH GERMANO LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 44 EDGE HILL RD
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City | MILTON
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State | MA
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Zip | 02186-5309
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Country | US
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Telephone | 617-696-4285
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Fax |
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Provider Business Mailing Address
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Address Line | 131 WEBSTER AVE
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City | MARSHFIELD
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State | MA
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Zip | 02050-5174
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Country | US
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Telephone | 617-733-6419
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 221253
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License Number State | MA
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