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1124561451
EDWIN W WILLIS
BOSTON, MA
NPI
1124561451
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MA 1810 LADC1)
Enumeration Date
2016-11-18
Last Update Date
2016-11-18
Business Address
-- EDWIN W WILLIS
774 ALBANY ST
BOSTON, MA 02118-2520
Phone number: 617-534-5613
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Mailing Address
-- EDWIN W WILLIS
1010 MASSACHUSETTS AVE
BOSTON, MA 02118-2600
Phone number: 617-419-3408
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