Individual
LILLIAN DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, BSN, RN
Contact information
Practice address
238 HIGH ST, CANTON, MA 02021-3654
(617) 755-6020
Mailing address
25 OWENCROFT RD, DORCHESTER, MA 02124-4723
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2302862
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2302862
MA
Other
Enumeration date
01/17/2018
Last updated
03/05/2025
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