Individual
KATHLEEN BLASCAK PONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
950 WINTER ST, WALTHAM, MA 02451-1424
(413) 862-4002
(781) 419-8479
Mailing address
950 WINTER ST, WALTHAM, MA 02451-1424
(413) 862-4002
(781) 419-8479
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
236539
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN236539
MA
Other
Enumeration date
10/09/2008
Last updated
02/15/2018
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