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Individual

MARY COAKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, BC

Contact information

Practice address
2364 WASHINGTON ST, NEWTON, MA 02462-1440
(617) 332-2047
(617) 332-7341
Mailing address
2364 WASHINGTON ST, NEWTON, MA 02462-1440
(617) 332-2047
(617) 332-7341

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
83284
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PN0235
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/23/2006
Last updated
04/10/2008
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