Organization
ADULLAM INTEGRATED PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERICK YENSILA NGORAN (PMHNP-BC)
(701) 610-1994
Entity
Organization
Contact information
Practice address
155 FEDERAL ST STE 700, BOSTON, MA 02110-1727
(701) 610-1994
Mailing address
155 FEDERAL ST STE 700, BOSTON, MA 02110-1727
(701) 610-1994
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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