MEDICARE: MS. JENNIFER LESLIE PARKER L.I.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	106980	MA

General Provider Information

NPI Number	:	1083182125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LESLIE PARKER L.I.C.S.W.

Provider Business Mailing Address
First Line	:	10 HUNT RD
Second Line	:
City	:	NEW SALEM
State	:	MA
Zip	:	01355-5506
Country	:	US
Telephone Number	:	413-687-2926
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 HUNT RD
Second Line	:
City	:	NEW SALEM
State	:	MA
Zip	:	01355-5506
Country	:	US
Telephone Number	:	413-687-2926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2018
Last Update Date	:	11/07/2018

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