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Wyatt Tucker Pasco
Peer Specialist in Concord, Massachusetts
NPI 1194407528

Wyatt Tucker Pasco is a Peer Specialist based in Concord, MA. Wyatt Tucker Pasco practices in Concord, MA. The NPI Number for Wyatt Tucker Pasco is 1194407528 and holds a License No. (Massachusetts).

The current practice location address for Wyatt Tucker Pasco is 76 Gifford Ln, Concord, MA and can be reached out via phone at 617-800-6697.

Location: 76 Gifford Ln, Concord, MA, 01742-2235
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194407528
Provider Name
Wyatt Tucker Pasco
Credential
Provider Entity Type
Individual
Gender
Male
Address
76 Gifford Ln, Concord, MA, 01742-2235
Phone Number
617-800-6697
Fax Number
Provider Enumeration Date
08/04/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
76 Gifford Ln
City
Concord
State
Massachusetts
Zip
01742-2235
Phone Number
617-800-6697
Fax Number
person
Provider Business Mailing Address Details
Address
76 Gifford Ln
City
Concord
State
Massachusetts
Zip
01742-2235
Phone Number
617-800-6697
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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