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General NPI Number Information
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NPI Number | 1770160749
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Entity Type | Organization
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Legal Business Name | WHOLESOME PSYCHIATRY, LLC
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 10 ANDREW SQ STE 201B
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City | SOUTH BOSTON
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State | MA
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Zip | 02127-3037
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Country | US
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Telephone | 617-820-7677
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Fax |
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Provider Business Mailing Address
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Address Line | 301 UNION ST
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City | HANOVER
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State | MA
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Zip | 02339-1542
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Country | US
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Telephone | 617-820-7677
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | DOROTA BORKIEWICZ
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Credential | NP
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Telephone | 617-820-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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