Kenneth B Jaeger, LICSW
Social Worker, Clinical in Brighton, MA. Individual provider (NPI-1).
NPI number1730281007
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1730281007
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kenneth B Jaeger
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 113372 | MA | Yes |
Practice location
77b Warren StBrighton, MA 02135-3601
Phone 617-787-1901 · Fax 617-254-3461
Mailing address
77b Warren StBrighton, MA 02135-3601
Phone 617-787-1901 · Fax 617-254-3461
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