Individual
SERITA RENEE WILSON-CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
398 NEPONSET AVE, BOSTON, MA 02122-3134
(617) 323-2800
Mailing address
1 POPES HILL ST, BOSTON, MA 02122-3310
(617) 733-0556
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2359781
MA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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