Provider Demographics
NPI:1538569371
Name:JUARBE, NEREIDA
Entity type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:JUARBE
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 1:3313 WASHINGTON ST.
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-522-0650
Mailing Address - Fax:617-522-0652
Practice Address - Street 1:3313 WASHINGTON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2691
Practice Address - Country:US
Practice Address - Phone:617-522-0650
Practice Address - Fax:617-522-0652
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor