Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003112897 |
---|---|
Provider Name | Ms. Maryann Touchette |
First Address | Malden, MA 02148-3058 |
Second Address | Malden, MA 02148-3058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2011 |
Last Update Date | 27/01/2011 |