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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