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General NPI Number Information
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NPI Number | 1417664905
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Entity Type | Organization
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Legal Business Name | DELLA MENTE THERAPEUTICS
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 435 NEWBURY ST STE 206
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City | DANVERS
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State | MA
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Zip | 01923-1065
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Country | US
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Telephone | 978-208-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 435 NEWBURY ST STE 206
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City | DANVERS
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State | MA
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Zip | 01923-1065
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Country | US
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Telephone | 978-208-2280
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Fax |
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Authorized Official
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Title or Position | OWNER/NP
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Name | KATHLEEN PUCCI
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Credential | NP
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Telephone | 978-912-4068
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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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