| Street | 140 Chadwick St |
| City/Town | Portland |
| State/Province/Region | Massachusetts |
| Zip/Postal Code | 04102 |
| Phone Number | (207) 774-5141 |
| Country | United States |
| Latitude | 43.651696 |
| Longitude | -70.274627 |
| Full Name | Dr. Clarissa Jacobi V |
| Gender | female |
| Birthday | 1987-04-22 |
| Social Security Number | 007-11-0728 |
| Credit card brand | EnRoute |
| Credit card number | 2014994912127796 |
| Expire | 2027/10 |
| CVV | 850 |