Most Relevant Information
Provider Data
| NPI Number: | 1003004292 |
| Provider Name: | JEAN MARQUES LAFOREST COUNSELOR |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/12/2007 |
| Last Updated: | 10/12/2007 |
Provider Practice Location
230 HIGHLAND AVE
S.O.N, ROOM 401
SOMERVILLE
MA
021431408
Practice Location Phone/Fax
| Phone: | 6175916780 |
| Fax: | 6175916784 |
Provider Mailing Location
230 HIGHLAND AVE
S.O.N, ROOM 401
SOMERVILLE
MA
021431408
Provider Mailing Phone/Fax
| Phone: | 6175916780 |
| Fax: | 6175916784 |