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Individual

LARISA BELISLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RNCS

Contact information

Practice address
300 LINDEN PONDS WAY, HINGHAM, MA 02043-3769
(781) 534-7100
(781) 534-7358
Mailing address
5525 RESEARCH PARK DR FL 4, BALTIMORE, MD 21228-4873
(781) 534-7100
(781) 534-7358

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
154303
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
522239464
TRICARE NORTH
01
83-16599
EVERCARE
Enumeration date
05/12/2006
Last updated
10/20/2016
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