Individual
MARY ROSE WEYRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 HEATH ST, JAMAICA PLAIN, MA 02130-1650
(617) 523-6400
(617) 523-3034
Mailing address
31 HEATH ST, JAMAICA PLAIN, MA 02130-1650
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303414
—
MA
Enumeration date
09/24/2015
Last updated
09/24/2015
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