Individual
LARISA BELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
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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