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General NPI Number Information
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NPI Number | 1417679770
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Entity Type | Organization
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Legal Business Name | SOUTH OF BOSTON PSYCHIATRIC & EMOTIONAL SUPPORT LLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 133 WASHINGTON ST
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City | NORWELL
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State | MA
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Zip | 02061-1755
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Country | US
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Telephone | 781-925-1106
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Fax |
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Provider Business Mailing Address
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Address Line | 133 WASHINGTON ST
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City | NORWELL
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State | MA
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Zip | 02061-1755
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | LINDA SHEPPARD-REECE
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Credential | NP
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Telephone | 617-404-5253
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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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