Provider Demographics
NPI:1992456321
Name:GERZON, JEANNETTE L (EDD (PSYCHOLOGIST))
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:L
Last Name:GERZON
Suffix:
Gender:F
Credentials:EDD (PSYCHOLOGIST)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-3758
Mailing Address - Country:US
Mailing Address - Phone:508-574-9091
Mailing Address - Fax:
Practice Address - Street 1:20 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-3758
Practice Address - Country:US
Practice Address - Phone:508-574-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6449103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling