Individual
NILSON MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 ISLAND ST, LAWRENCE, MA 01840-1868
(617) 848-9091
Mailing address
50 ISLAND ST, LAWRENCE, MA 01840-1868
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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