Individual
MS. KIM ILENE TAMAREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,LMHC
Contact information
Practice address
1 RUSSELL CIR, NATICK, MA 01760-1223
(781) 302-4771
(781) 302-4635
Mailing address
1 RUSSELL CIR, NATICK, MA 01760-1223
(781) 302-4771
(781) 302-4635
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
452
MA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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