Individual
JULISSA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
359 LOWELL ST, LAWRENCE, MA 01841-4338
(978) 973-9734
Mailing address
359 LOWELL ST, LAWRENCE, MA 01841-4338
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
S21559274
MA
103T00000X
Psychologist
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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