Individual
PRINCEWILL FONTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
132 CHIEF JUSTICE CUSHING HWY STE 70, COHASSET, MA 02025-1259
(781) 469-8034
Mailing address
132 CHIEF JUSTICE CUSHING HWY STE 70, COHASSET, MA 02025-1259
(781) 469-8034
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
L8-0010342
DE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2307255
MA
Other
Enumeration date
07/19/2022
Last updated
10/11/2024
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