My Self Oath, Inc | |
33 Dover St Ste 317 Brockton MA 02301-5973 | |
(508) 521-9044 | |
Not Available |
Full Name | My Self Oath, Inc |
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Speciality | Counselor - Mental Health |
Location | 33 Dover St Ste 317, Brockton, Massachusetts |
Authorized Official Name and Position | Yleis Ashley Engerman (PRACTICE OWNER) |
Authorized Official Contact | 5085219044 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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My Self Oath, Inc 80 Old Stone Way Apt 103 Weymouth MA 02189-2537 Ph: (617) 512-0001 | My Self Oath, Inc 33 Dover St Ste 317 Brockton MA 02301-5973 Ph: (508) 521-9044 |
NPI Number | 1285246959 |
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Provider Enumeration Date | 08/23/2020 |
Last Update Date | 08/23/2020 |
Certification Date | 08/23/2020 |
Identifier | Type | State | Issuer |
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1285246959 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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