Individual
MARISA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1216 COMMONWEALTH AVE, ALLSTON, MA 02134-4638
(617) 739-0046
Mailing address
16 BANKS ST, WINTHROP, MA 02152-1904
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60792
MA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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