Individual
DESIREE ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44 MOULTRIE ST, BOSTON, MA 02124-2230
(617) 615-6577
Mailing address
PO BOX 1159, RANDOLPH, MA 02368-1159
(617) 615-6577
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
03/29/2023
Last updated
03/22/2024
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