Basic Information
| Provider Information | |||||||||
| NPI: | 1225540438 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POIRIER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 PARTRIDGE HILL RD | ||||||||
| Address2: | |||||||||
| City: | BILLERICA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018211248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785022368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22 OLD CANAL DR | ||||||||
| Address2: | |||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018512730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784536800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2017 | ||||||||
| LastUpdateDate: | 10/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 491540 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.