Individual
BELICE PUENTES QUENGUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 435-4833
Mailing address
100 RIVERS EDGE DR UNIT 318, MEDFORD, MA 02155-5470
(617) 435-4833
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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