Individual
BRIAN BOURASSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 BOSTON ST, SALEM, MA 01970-1402
(603) 915-6390
Mailing address
10 TRASK CT APT 21, BEVERLY, MA 01915-5375
(603) 915-6390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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