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Peter Jerome Moulton
Student in an Organized Health Care Education/Training Program in Waltham, Massachusetts
NPI 1669952032

Peter Jerome Moulton is a Student in an Organized Health Care Education/Training Program based in Waltham, MA. Peter Jerome Moulton practices in Waltham, MA. The NPI Number for Peter Jerome Moulton is 1669952032 and holds a License No. (Massachusetts).

The current practice location address for Peter Jerome Moulton is 77 Rumford Ave, Waltham, MA and can be reached out via phone at 781-894-4325.

Location: 77 Rumford Ave, Waltham, MA, 02453-3872
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669952032
Provider Name
Peter Jerome Moulton
Credential
Provider Entity Type
Individual
Gender
Male
Address
77 Rumford Ave, Waltham, MA, 02453-3872
Phone Number
781-894-4325
Fax Number
Provider Enumeration Date
08/15/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
77 Rumford Ave
City
Waltham
State
Massachusetts
Zip
02453-3872
Phone Number
781-894-4325
Fax Number
person
Provider Business Mailing Address Details
Address
77 Rumford Ave
City
Waltham
State
Massachusetts
Zip
02453-3872
Phone Number
781-894-4325
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Massachusetts)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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