Individual
MICHAEL J SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, LADC 1
Contact information
Practice address
8 FARNHAM ST, BOSTON, MA 02119-2962
(508) 241-2176
Mailing address
8 FARNHAM ST, BOSTON, MA 02119-2962
(617) 971-9360
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13160
MA
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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