Healthcare Provider Details

I. General information

NPI: 1578480489
Provider Name (Legal Business Name): AV THERAPY AND PRESCRIBING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 LEAMINGTON RD
BRIGHTON MA
02135-4016
US

IV. Provider business mailing address

36 LEAMINGTON RD
BRIGHTON MA
02135-4016
US

V. Phone/Fax

Practice location:
  • Phone: 617-651-1080
  • Fax:
Mailing address:
  • Phone: 617-651-1080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ALDONA ANGELE VAINIUS
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: CNP
Phone: 617-651-1080