Individual
LINDA LOTIVE SIMWATACHELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
Mailing address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95053526
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2371987
MA
Other
Enumeration date
09/30/2020
Last updated
12/13/2024
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