Individual
PHALNARITH BA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OUT REACH WORKER
Contact information
Practice address
265 BEACH ST, REVERE, MA 02151-3131
(617) 912-7732
(781) 286-5636
Mailing address
265 BEACH ST, REVERE, MA 02151-3131
(617) 912-7732
(781) 286-5636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171R00000X
Interpreter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301659
—
MA
Enumeration date
02/01/2007
Last updated
09/11/2025
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