Provider Demographics
NPI:1174984827
Name:SCHMID, JENNA MEZIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:MEZIN
Last Name:SCHMID
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:MEZIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:75 MT AUBURN ST 4 EAST
Mailing Address - Street 2:HARVARD UNIVERSITY HEALTH SERVICES
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 MT AUBURN ST 4 EAST
Practice Address - Street 2:HARVARD UNIVERSITY HEALTH SERVICES
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-495-2042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical