Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1003455395 |
---|---|
Provider Name | Desirae Messina |
First Address | Haverhill, MA 01835-8515 |
Second Address | Haverhill, MA 01835-8515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2020 |
Last Update Date | 03/01/2020 |