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General NPI Number Information
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NPI Number | 1730604661
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Entity Type | Individual
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Provider Name | GRECIA AYBAR
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Gender | Female
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11 WHITE STREET
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City | LOWELL
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State | MA
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Zip | 01854
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Country | US
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Telephone | 978-319-3391
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Fax |
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Provider Business Mailing Address
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Address Line | 11 WHITE ST
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City | LOWELL
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State | MA
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Zip | 01854-2830
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Country | US
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Telephone | 978-319-3391
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | S89429861
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | S89429861
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License Number State | MA
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