Individual
TATIANA CENTEIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
20 MEADOWBROOK RD, BROCKTON, MA 02301-7122
(508) 638-6003
Mailing address
73 LEAVITT ST APT 2, BROCKTON, MA 02301-5163
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN91792
MA
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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