Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | S15495922 | MA |
NPI | 1003001413 |
---|---|
Provider Name | Miss Gina Marie Rabbitt |
First Address | Salem, MA 01970-6839 |
Second Address | Salem, MA 01970-4815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 10/09/2007 |