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General NPI Number Information
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NPI Number | 1366304883
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Entity Type | Organization
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Legal Business Name | IMMERSION THROUGH THERAPY, PLLC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 100 MERRIMACK ST
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City | LOWELL
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State | MA
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Zip | 01852-1708
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Country | US
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Telephone | 617-640-1261
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MERRIMACK ST
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City | LOWELL
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State | MA
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Zip | 01852-1708
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Country | US
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Telephone | 617-640-1261
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | DANIELLE SANON-JOSEPH
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Credential |
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Telephone | 617-640-1261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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