Lakeside Mental Health, Pllc
NPI #1619494168 in Lakeville, Massachusetts
Provider Information
- NPI Number
- 1619494168
- Entity Type
- Organization
- Organization Name
- Lakeside Mental Health, Pllc
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Aug 25, 2017
- Last Updated
- Aug 25, 2017
Practice Location
- Address
- 104 CHARLES ELDRIDGE DRIVE STE 1
- City
- Lakeville
- State
- Massachusetts
- ZIP Code
- 02347-1388
- Phone
- (774) 213-9332
Authorized Official
- Name
- MRS. EMILY-ROSE MONTGOMERY VIRDEN, PMHNP-BC
- Title
- OWNER/ NURSE PRACTITIONER
- Phone
- (774) 213-9332
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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