Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1114295581 |
---|---|
Provider Name | Miss Tamara Lynne Wills |
First Address | Watertown, MA 02471-0084 |
Second Address | Natick, MA 01760-1622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2011 |
Last Update Date | 07/01/2013 |