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General NPI Number Information
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NPI Number | 1861204745
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Entity Type | Organization
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Legal Business Name | HARBOR WELLNESS, PLLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 5 RICHFIELD CIRCLE
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City | CARVER
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State | MA
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Zip | 02330
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Country | US
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Telephone | 508-422-0404
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Fax | 508-422-0404
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Provider Business Mailing Address
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Address Line | 6 LIBERTY SQ STE 91536
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City | BOSTON
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State | MA
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Zip | 02109-5800
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Country | US
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Telephone | 508-422-0404
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Fax | 508-422-0404
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICAL
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Name | WAYNE ETHIER
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Credential | MSN
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Telephone | 508-422-0404
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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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