Organization
CHOATE HEALTH MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL A. PORDER M.A. (DIRECTOR)
(978) 322-5120
Entity
Organization
Contact information
Practice address
391 VARNUM AVE, LOWELL, MA 01854-2119
(978) 322-5120
Mailing address
391 VARNUM AVE, LOWELL, MA 01854-2119
(978) 322-5120
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307126
—
MA
Enumeration date
12/12/2006
Last updated
08/22/2020
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