Individual
YESSICA LABOUR AGUASVIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
45 DIMOCK ST, ROXBURY, MA 02119-1208
(617) 442-8800
Mailing address
16 BAIRD ST APT 2, DORCHESTER, MA 02124-2872
(781) 353-4637
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2322181
MA
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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