Individual
MRS. LACEY MARIE SELLATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LICAC, PA-C
Contact information
Practice address
626 MAIN ST, BOLTON, MA 01740-3302
(978) 610-6247
Mailing address
565 WINTER ST, FRAMINGHAM, MA 01702-5632
(781) 424-0974
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
269439
MA
171100000X
Acupuncturist
Primary
239503
MA
202D00000X
Integrative Medicine Physician
239503
MA
202D00000X
Integrative Medicine Physician
PA5404
MA
363A00000X
Physician Assistant
PA5404
MA
Other
Enumeration date
02/04/2009
Last updated
07/07/2023
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