Provider Demographics
NPI:1053963892
Name:FERRER, JESSICA NAZARENO (LMT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NAZARENO
Last Name:FERRER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7043
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-7043
Mailing Address - Country:US
Mailing Address - Phone:339-368-6669
Mailing Address - Fax:
Practice Address - Street 1:35 BEDFORD ST STE 11
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4439
Practice Address - Country:US
Practice Address - Phone:339-368-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMT-4148225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist