Individual
DR. VANESSA E. FOSSOUO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
150 S HUNTINGTON AVE, JAMAICA PLAIN, MA 02130-4817
(617) 232-9500
Mailing address
12 RIDGEWOOD RD, SOUTH EASTON, MA 02375-1522
(978) 697-0118
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
27489
MA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
27489
MA
Other
Enumeration date
10/09/2008
Last updated
04/19/2016
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