Individual
FADIALA MARIE BEAUVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148 WARREN ST, LOWELL, MA 01852-2208
(978) 452-1736
Mailing address
148 WARREN ST, LOWELL, MA 01852-2208
(978) 452-1736
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S53922660
MA
Other
Enumeration date
11/09/2011
Last updated
11/09/2011
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