Individual
ELIZABETH KATHRYN COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 PARK AVE, WORCESTER, MA 01610-1021
(508) 767-1732
Mailing address
320 PARK AVE, WORCESTER, MA 01610-1021
(508) 767-1732
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH239896
MA
183700000X
Pharmacy Technician
PI164293
MA
Other
Enumeration date
06/21/2020
Last updated
11/09/2020
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