Individual
ALICE WANGERWE MBOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
229 18TH ST APT 201, DRACUT, MA 01826-5173
(978) 319-1229
Mailing address
229 18TH ST APT 201, DRACUT, MA 01826-5173
(978) 319-1229
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2316787
MA
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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