Provider Demographics
NPI:1144722216
Name:ABREU, JAYLIN ARIANA
Entity type:Individual
Prefix:
First Name:JAYLIN
Middle Name:ARIANA
Last Name:ABREU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MONTROSE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2107
Mailing Address - Country:US
Mailing Address - Phone:413-455-4737
Mailing Address - Fax:
Practice Address - Street 1:7 MONTROSE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2107
Practice Address - Country:US
Practice Address - Phone:413-455-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAN0014132501Medicaid