Provider Demographics
NPI:1275205510
Name:JAIN, SURABHI (MS)
Entity type:Individual
Prefix:
First Name:SURABHI
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1193
Mailing Address - Country:US
Mailing Address - Phone:508-589-5333
Mailing Address - Fax:774-250-2693
Practice Address - Street 1:77 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1193
Practice Address - Country:US
Practice Address - Phone:508-589-5333
Practice Address - Fax:774-250-2693
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician