Individual
INDERJIT RANGAMOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 586-6300
Mailing address
95 W SQUANTUM ST, APT 718, NORTH QUINCY, MA 02171-2123
(617) 302-4360
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C0600052
OH
101YM0800X
Mental Health Counselor
C0600052
OH
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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