Facts
- Status
- A
- Credential
- MS, LMHC
- Type
- Individual
- Enumeration date
- 2007-02-01
- Last updated
- 2024-07-27
Specialties
Licenses
- License MA
- 6174
Location
- Practice location
- 243 MAIN ST
- City
- BOURNE MA
- Postal code
- 025323234
- Phone
- 774-836-3738
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.