Individual
MRS. JULIE ELLEN LYSIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN MS CS
Contact information
Practice address
148 WORCESTER ST, WEST BOYLSTON, MA 01583-1751
(508) 835-1735
Mailing address
24 ASNEBUMSKIT RD, PAXTON, MA 01612-1351
(508) 752-5621
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
210641
MA
Other
Enumeration date
02/04/2007
Last updated
07/08/2007
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