Individual
SHALISHA KIMBERLY CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 HARRISON AVE, BOSTON, MA 02118-4001
(617) 414-5245
(617) 638-6836
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN280992
MA
Other
Enumeration date
04/28/2009
Last updated
10/16/2014
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