Individual
ANGELIE M DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
365 EAST ST, TEWKSBURY, MA 01876-1950
(857) 293-2881
Mailing address
365 EAST ST, TEWKSBURY, MA 01876-1950
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213669078
—
MA
Enumeration date
02/17/2021
Last updated
02/17/2021
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