Individual
KATE STACEY VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 HIGHLAND AVE, SOMERVILLE, MA 02143-1422
(617) 852-3796
Mailing address
212 HIGHLAND AVE, SOMERVILLE, MA 02143-1422
(617) 852-3796
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN2339969
MA
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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