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General NPI Number Information
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NPI Number | 1275790644
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Entity Type | Organization
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Legal Business Name | ANOTHER CHANCE THERAPY AND COACHING
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 465 NASHUA RD SUITE 6
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City | DRACUT
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State | MA
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Zip | 01826-2944
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Country | US
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Telephone | 978-771-0840
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Fax |
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Provider Business Mailing Address
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Address Line | 465 NASHUA RD SUITE 6
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City | DRACUT
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State | MA
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Zip | 01826-2944
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Country | US
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Telephone | 978-771-0840
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. COLLEEN KENDALL DUCHARME
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Credential | LICSW
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Telephone | 978-771-0840
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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 | 113614
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License Number State | MA
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