Organization
MOMENTOM WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE OFRIA MS, RN, FPMHNP-BC (OWNER/SOLE MEMBER)
(508) 237-5886
Entity
Organization
Contact information
Practice address
1336 MAIN ST, OSTERVILLE, MA 02655-1542
(508) 237-5886
Mailing address
955 MAIN ST, OSTERVILLE, MA 02655-2031
(508) 237-5886
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
12/27/2021
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