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General NPI Number Information
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NPI Number | 1417326398
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Entity Type | Individual
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Provider Name | LISA K BRESLIN LCMT
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Gender | Female
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 27 CONGRESS ST STE 203
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City | SALEM
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State | MA
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Zip | 01970-5576
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Country | US
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Telephone | 617-833-3781
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 247 27 CONGRESS ST. #203
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City | SALEM
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State | MA
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Zip | 01970-0247
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Country | US
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Telephone | 617-833-3781
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 5085
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License Number State | MA
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