Individual
PROF. JACQUELINE DISSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 FRANKLIN TER, LONGMEADOW, MA 01106-2632
(443) 824-0842
Mailing address
40 FRANKLIN TER, LONGMEADOW, MA 01106-2632
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2313873
MA
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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