Individual
DESOLA-VASILISA BAMGBALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
16 ISLAND HILL AVE UNIT 310, MELROSE, MA 02176-6140
(917) 340-6534
Mailing address
16 ISLAND HILL AVE UNIT 310, MELROSE, MA 02176-6140
(917) 340-6534
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN2373211
MA
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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