Organization
KOKORO WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE JACKSON (OWNER/PRESIDENT)
(508) 223-7801
Entity
Organization
Contact information
Practice address
53 GATSBY DR APT D, RAYNHAM, MA 02767-8001
(508) 223-7801
Mailing address
53D GATSBY DRIVE, RAYNHAM, MA 02780
(508) 223-7801
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7728
MA
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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