Individual
ALEXANDRIA LYNN SUPERNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 UNION ST, WORCESTER, MA 01608-1141
(774) 255-0674
Mailing address
20B GATES RD, WORCESTER, MA 01603-1839
(774) 312-8198
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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