Individual
SAMUELLE A JEAN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
645 BROADWAY, SOMERVILLE, MA 02145-2528
(781) 712-6141
Mailing address
147 CLIFTON ST UNIT 2, MALDEN, MA 02148-2526
(857) 389-4086
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2291984
MA
Other
Enumeration date
06/11/2024
Last updated
05/08/2025
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