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Organization

WARRIOR'S PATH

Active
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Organization

WARRIOR'S PATH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LARISA KOUPERSCHMIDT MD (MEDICAL DIRECTOR)
(617) 921-0119
Entity
Organization

Contact information

Practice address
200 S MAIN ST, ATTLEBORO, MA 02703-4006
(508) 921-0119
Mailing address
258-A MAIN STREET, #326, MEDFIELD, MA 02052

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
000010244
MA
2084P0800X
Psychiatry Physician
Primary
246627
MA

Other

Enumeration date
08/16/2017
Last updated
06/16/2018
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