Organization
WILLIS CENTER
Active
Organization
WILLIS CENTER
Active
Other names
Henry Lee WIllis
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANNE SANSOUCY MA CAGS LMHC (CLINICIAN)
(508) 799-2934
Entity
Organization
Contact information
Practice address
44 FRONT ST, FOURTH FLOOR, WORCESTER, MA 01608-1733
(508) 799-2934
Mailing address
91 KENBERMA ROAD, APARTMENT #2, WORCESTER, MA 01604
(508) 479-9310
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
6707
MA
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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