Individual
CORRIE VANDERBRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
(617) 264-5305
Mailing address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
221700000X
Art Therapist
—
—
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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