Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 280997 | MA |
NPI | 1003491119 |
---|---|
Provider Name | Irene Muchai |
First Address | Dunstable, MA 01827-2405 |
Second Address | Lawrence, MA 01840-1772 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 11/01/2022 |