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General NPI Number Information
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NPI Number | 1982464475
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Entity Type | Organization
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Legal Business Name | TC WELLNESS PRACTICE
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 84 HIGHLAND AVE STE 304
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City | SALEM
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State | MA
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Zip | 01970-2733
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Country | US
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Telephone | 978-624-6245
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Fax | 978-219-2238
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Provider Business Mailing Address
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Address Line | 84 HIGHLAND AVE STE 304
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City | SALEM
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State | MA
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Zip | 01970-2733
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Country | US
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Telephone | 978-624-6245
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Fax | 978-219-2238
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. THERESE D CHAPAJONG
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Credential |
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Telephone | 978-624-6245
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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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