Most Relevant Information
Provider Data
| NPI Number: | 1003184250 |
| Provider Name: | MOIRAR M. LEVEILLE MASTERS INTERN MHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/02/2011 |
| Last Updated: | 12/02/2011 |
Provider Practice Location
20 VESPER LANE L-1
NANTUCKET
MA
02554
Practice Location Phone/Fax
| Phone: | 5082282689 |
| Fax: | 5082283613 |
Provider Mailing Location
P O BOX 2895
NANTUCKET
MA
02584
Provider Mailing Phone/Fax
| Phone: | 5086151885 |
| Fax: | 5082283613 |