Individual
AMANDA GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 SUMMER ST, BARRE, MA 01005-9557
(508) 241-0979
Mailing address
PO BOX 130, BARRE, MA 01005-0130
(508) 241-0979
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2280142
MA
Other
Enumeration date
07/15/2020
Last updated
07/29/2021
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