Individual
TERESA PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UMASS MEMORIAL MEDICAL CENTER, 55 LAKE AVENUE NORTH, PSYCHIATRY, WORCESTER, MA 01655
(508) 334-1000
Mailing address
UMASS MEMORIAL MEDICAL CENTER, 55 LAKE AVENUE NORTH, PSYCHIATRY, WORCESTER, MA 01655
(508) 334-1000
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0148RC
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0148RC
RECOVERY COACH CERTIFICATION
MA
Enumeration date
07/31/2020
Last updated
07/31/2020
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