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General NPI Number Information
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NPI Number | 1033160304
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Entity Type | Individual
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Provider Name | LARISA BELISLE RNCS
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 300 LINDEN PONDS WAY
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City | HINGHAM
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State | MA
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Zip | 02043-3769
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Country | US
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Telephone | 781-534-7100
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Fax | 781-534-7358
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Provider Business Mailing Address
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Address Line | 5525 RESEARCH PARK DR FL 4
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City | BALTIMORE
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State | MD
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Zip | 21228-4873
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Country | US
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Telephone | 781-534-7100
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Fax | 781-534-7358
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 154303
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License Number State | MA
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