Individual
MS. MARIA S. AVILA-WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
55 FRUIT ST, YAWKEY CENTER 9E, BOSTON, MA 02114-2621
(617) 724-4800
(617) 724-6898
Mailing address
55 FRUIT ST, YAWKEY CENTER 9E, BOSTON, MA 02114-2621
(617) 724-4800
(617) 724-6898
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
206032
MA
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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