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General NPI Number Information
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NPI Number | 1104745694
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Entity Type | Individual
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Provider Name | EMILY ROSE NELSON
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Gender | Female
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 110 BEACHVIEW RD
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City | EAST BOSTON
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State | MA
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Zip | 02128-1001
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Country | US
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Telephone | 617-635-8422
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Fax |
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Provider Business Mailing Address
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Address Line | 299 MAVERICK ST APT 3
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City | EAST BOSTON
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State | MA
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Zip | 02128-3727
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Country | US
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Telephone | 562-805-7398
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 230574
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License Number State | MA
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