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Individual

SOCKVIECHHEA THOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
41 HIGHLAND AVE, WINCHESTER, MA 01890-1446
(781) 756-7095
Mailing address
80 ROGERS ST UNIT 401, LOWELL, MA 01852-3690

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2287624
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2287624
MA
363LG0600X
Gerontology Nurse Practitioner
RN2287624
MA

Other

Enumeration date
11/02/2020
Last updated
06/15/2021
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