Jasmine Witkowski, PC
Clinic/Center, Adult Mental Health in Pembroke, MA. Organization (NPI-2).
NPI number1255005484
StatusActive
Last updated in NPPESAug 2, 2021
Details
- NPI
- 1255005484
- Entity type
- Organization (NPI-2)
- Legal business name
- Jasmine Witkowski, PC
- Organization subpart
- No
- Enumeration date
- Aug 2, 2021
- Certification date
- Aug 2, 2021
- Last updated
- Aug 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
28 Riverside DrPembroke, MA 02359-4947
Phone 774-766-7986
Mailing address
3 Briar Path WayCarver, MA 02330-1350
Phone 774-766-7986
Authorized official
Jasmine N Witkowski
President
7747667986
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