Basic Information
| Provider Information | |||||||||
| NPI: | 1891080735 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JUMET | ||||||||
| FirstName: | MARIETTE | ||||||||
| MiddleName: | CECILE SERVAIS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MSW/LSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HOMMEY | ||||||||
| OtherFirstName: | MARIETTE | ||||||||
| OtherMiddleName: | HELEN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 235 BALTIMORE ST | ||||||||
| Address2: | APT #1 | ||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173313256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244871453 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 50 ALDRIN RD | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023604827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088300000 | ||||||||
| FaxNumber: | 5085805162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2011 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SW129156 | PA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.