Individual
MRS. CHARLOTTE WASUKIIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 DIMOCK ST # 2119, ROXBURY, MA 02119-1029
(781) 375-6978
Mailing address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90E037C3-D314-4C18-8
CANS
MA
Enumeration date
09/27/2015
Last updated
11/19/2020
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