Individual
MARVEL LAROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
217 CHESTNUT ST, RANDOLPH, MA 02368-2407
(857) 991-0110
Mailing address
101 S MAIN ST, RANDOLPH, MA 02368-4896
(857) 991-0110
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN2292446
MA
Other
Enumeration date
07/22/2016
Last updated
12/05/2025
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