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General NPI Number Information
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NPI Number | 1417722463
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Entity Type | Organization
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Legal Business Name | SALT AND TIDES COUNSELING, LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 16 BROWN BEAR CIR
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City | PLYMOUTH
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State | MA
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Zip | 02360-7115
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Country | US
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Telephone | 781-733-5685
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Fax |
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Provider Business Mailing Address
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Address Line | 16 BROWN BEAR CIR
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City | PLYMOUTH
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State | MA
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Zip | 02360-7115
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Country | US
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Telephone | 781-733-5685
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Fax |
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Authorized Official
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Title or Position | OWNER AND PRACTITIONER
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Name | HILLARY EZRIN
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Credential | LRC, CRC
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Telephone | 781-733-5685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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