Individual
OGO GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 WASHINGTON ST STE 3, STOUGHTON, MA 02072-2971
(508) 345-5324
(781) 986-4616
Mailing address
810 WASHINGTON ST STE 3, STOUGHTON, MA 02072-2971
(508) 345-5324
(781) 986-4616
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
230084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110158499A
—
MA
Enumeration date
07/21/2019
Last updated
11/18/2022
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