Organization
PSYCHE1001 LEARN GROW CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARCI A MCNICOL APRNCNS BC (OWNER)
(508) 636-4769
Entity
Organization
Contact information
Practice address
638 ADAMSVILLE RD, SUITE 1001, WESTPORT, MA 02790-5031
(508) 636-4769
(508) 636-6463
Mailing address
638 ADAMSVILLE RD, WESTPORT, MA 02790-5031
(508) 636-4769
(508) 636-6463
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
APRN00561
RI
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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