Individual
PETER GITOBU INOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
691 GRAFTON ST STE 2, WORCESTER, MA 01604-3185
(508) 304-9804
Mailing address
25 BJORKLUND AVE, WORCESTER, MA 01605-1065
(774) 303-8186
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
LABA3932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114446432
BCBA
MA
Enumeration date
03/11/2022
Last updated
03/11/2022
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