Healthcare Provider Details

I. General information

NPI: 1043720170
Provider Name (Legal Business Name): DONNA MARIE AMARAL PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 DEAN ST
TAUNTON MA
02780-2725
US

IV. Provider business mailing address

349 TICKLE RD
WESTPORT MA
02790-4722
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-0006
  • Fax:
Mailing address:
  • Phone: 301-257-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN145869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: