Provider Demographics
NPI:1992520142
Name:DA SILVA TEIXEIRA, JAIANNY
Entity type:Individual
Prefix:
First Name:JAIANNY
Middle Name:
Last Name:DA SILVA TEIXEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAIANNY
Other - Middle Name:
Other - Last Name:DA SILVA TEIXEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JT
Mailing Address - Street 1:14 FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3000
Mailing Address - Country:US
Mailing Address - Phone:351-210-1300
Mailing Address - Fax:
Practice Address - Street 1:14 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3000
Practice Address - Country:US
Practice Address - Phone:617-782-6460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor