Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1562 | MA |
NPI | 1619003068 |
---|---|
Provider Name | Dr. Paula Maria Morrissette |
First Address | Worcester, MA 01605-2401 |
Second Address | Worcester, MA 01605-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |