Individual
PATRICK DELVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
89R RUSSELL ST, EVERETT, MA 02149-4125
(857) 251-4928
Mailing address
89R RUSSELL ST, EVERETT, MA 02149-4125
(857) 251-4928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A9667450663
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/25/2022
Last updated
01/25/2022
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