Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003111394 |
---|---|
Provider Name | Emily Anna Pecora |
First Address | Gloucester, MA 01930-1571 |
Second Address | Gloucester, MA 01930-1571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2011 |
Last Update Date | 18/01/2011 |