Individual
CHELSEA R MONDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Mailing address
520 DUDLEY ST, ROXBURY, MA 02119-2769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124253794
—
MA
Enumeration date
09/27/2018
Last updated
09/27/2018
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