Jessica Michelle Rudolph | Marlborough, MA • PECOS Search

Jessica Michelle Rudolph

Behavior Technician

Behavioral Health & Social Service Providers

22 Cedar Hill Street, Suite 200, Marlborough, MA 01752

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Michelle Rudolph does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1235754664
Provider Type
Individual
Full Name
Rudolph, Jessica Michelle
Title
Miss

Gender
Female
Sole Proprietor
No
Enumeration Date
6/11/2020
Last Updated
6/11/2020

Contact Information

Practice Location

22 Cedar Hill Street, Suite 200, Marlborough, MA 01752

Unlisted Fax

Mailing Location

18 George St, Winthrop, MA 02152-3110

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer