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Individual

MS. DALE KAREN DEFORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN CS

Contact information

Practice address
30 FEDERAL ST, STE B, SALEM, MA 01970
(978) 740-9590
(978) 744-5486
Mailing address
30 FEDERAL ST, STE B, SALEM, MA 01970
(978) 740-9590
(978) 744-5486

Taxonomy

Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
110410
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1898493
MA
Enumeration date
12/05/2005
Last updated
07/08/2007
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