Individual
SIMA FAZLOLLAHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37 WATER ST STE 1, WAKEFIELD, MA 01880-3044
(781) 851-2648
Mailing address
37 WATER ST, WAKEFIELD, MA 01880-3058
(857) 917-9000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
03/21/2023
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