Provider Demographics
NPI:1053160507
Name:JASO, BRITTANY ALBERTA (PHD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ALBERTA
Last Name:JASO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 S HUNTINGTON AVE APT 414
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4850
Mailing Address - Country:US
Mailing Address - Phone:203-996-8909
Mailing Address - Fax:
Practice Address - Street 1:161 S HUNTINGTON AVE APT 414
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4850
Practice Address - Country:US
Practice Address - Phone:203-996-8909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPSY10000004103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty