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General NPI Number Information
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NPI Number | 1568316610
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Entity Type | Organization
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Legal Business Name | ENLIGHTEN THERAPEUTICS PLLC
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 3A POND RD
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City | GLOUCESTER
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State | MA
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Zip | 01930-1978
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Country | US
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Telephone | 978-587-5720
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Fax | 978-304-4034
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Provider Business Mailing Address
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Address Line | 3A POND RD
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City | GLOUCESTER
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State | MA
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Zip | 01930-1978
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Country | US
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Telephone | 978-587-5720
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Fax | 978-304-4034
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA WALLACE
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Credential | LIC. AC. MAOM
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Telephone | 978-587-5720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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