Individual provider · NPI-1
Lorraine Betwenik Gotlib, RNCS
Registered Nurse, Psych/Mental Health, Adult · Somerville, MA
NPI number1396799755
StatusActive
Last updated in NPPESApr 7, 2009
Details
- NPI
- 1396799755
- Entity type
- Individual (NPI-1)
- Name
- Lorraine Betwenik Gotlib
- Credential
- RNCS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 20, 2006
- Last updated
- Apr 7, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 116590 | MA | Yes |
Practice location
40 Holland StSomerville, MA 02144-2705
Phone 617-629-6180
Mailing address
147 Milk StProvider Enrollment 9th Floor
Boston, MA 02109-4806
Phone 617-559-8051
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