Individual
DECLAN FOTOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
600 PINE ST, LOWELL, MA 01851-2309
(978) 726-0056
Mailing address
600 PINE ST, LOWELL, MA 01851-2309
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024058381
MA
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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