Individual
SU RUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 LENOX ST, NORWOOD, MA 02062-3416
(339) 216-7712
Mailing address
270 BRIDGE ST, DEDHAM, MA 02026-1798
(339) 216-7712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/03/2021
Last updated
02/14/2022
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