Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 1387037 | MA |
NPI | 1205302742 |
---|---|
Provider Name | Jennifer Morway Balestracci |
First Address | Oxford, MA 01540-2613 |
Second Address | Charlton, MA 01507-1331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2018 |
Last Update Date | 23/10/2018 |