Individual
KELECHI JOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 LINCOLN ST STE 6, WORCESTER, MA 01605-2430
(774) 530-6955
(774) 530-6956
Mailing address
130 LINCOLN ST STE 6, WORCESTER, MA 01605-2430
(774) 530-6955
(774) 530-6956
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2285003
MA
Other
Enumeration date
01/12/2018
Last updated
10/05/2018
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