Organization
PEDIATRIC AND ADOLESCENT BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY J DUNN NP (PRACTICE OWNER)
(617) 697-2282
Entity
Organization
Contact information
Practice address
100 HIGH ST STE 200, WESTWOOD, MA 02090-1100
(617) 697-2282
Mailing address
86 WELLESLEY AVE, WELLESLEY, MA 02482-6634
(617) 697-2282
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110120284A
—
MA
Enumeration date
10/08/2019
Last updated
10/08/2019
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