Most Relevant Information
Provider Data
| NPI Number: | 1003354754 |
| Provider Name: | COURTNEY DESTREMPS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/02/2017 |
| Last Updated: | 02/02/2017 |
Provider Practice Location
14 PACELLA PARK DR
RANDOLPH
MA
023681756
Practice Location Phone/Fax
| Phone: | 7814400400 |
| Fax: |
Provider Mailing Location
14 PACELLA PARK DR
RANDOLPH
MA
023681756
Provider Mailing Phone/Fax
| Phone: | 7814400400 |
| Fax: |