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Individual

COURTNEY DESTREMPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
(781) 440-0400
Mailing address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
(781) 440-0400

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110026265E
MA
Enumeration date
02/02/2017
Last updated
02/02/2017
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