Individual
FANTASIA FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
(617) 469-8500
Mailing address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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