Individual
ILYSSA MARIE ANDINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 674-5400
Mailing address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 674-5400
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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