Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003125899 |
---|---|
Provider Name | Mrs. Nicole Ryann Tessier |
First Address | Taunton, MA 02780-2778 |
Second Address | Taunton, MA 02780-2778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2010 |
Last Update Date | 28/09/2010 |