Individual
MRS. DUSUBA MMAH KOROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
170 MAIN ST # G4-G8, TEWKSBURY, MA 01876-1765
(781) 348-9041
(978) 455-0274
Mailing address
17 DAWN AVE, MERRIMACK, NH 03054-4253
(603) 579-9916
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13060
MA
Other
Enumeration date
12/06/2011
Last updated
02/15/2022
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