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General NPI Number Information
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NPI Number | 1689780702
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Entity Type | Individual
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Provider Name | DONNA F. JENKINS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 599 NORTH AVE DOOR 8
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City | WAKEFIELD
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State | MA
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Zip | 01880-1648
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Country | US
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Telephone | 781-224-9884
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Fax | 781-224-9632
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Provider Business Mailing Address
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Address Line | 9 PHEASANT LN
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City | GROVELAND
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State | MA
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Zip | 01834-2030
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Country | US
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Telephone | 978-374-1351
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Fax | 781-224-9632
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6047
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License Number State | MA
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