Provider Demographics
NPI:1477278091
Name:TOWERLIGHT HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:TOWERLIGHT HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:OSHETISI
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAGBARE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CNP, PMHNP-BC
Authorized Official - Phone:781-768-7290
Mailing Address - Street 1:13 STEEPLE ST STE 202-37
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3287
Mailing Address - Country:US
Mailing Address - Phone:781-768-7290
Mailing Address - Fax:
Practice Address - Street 1:13 STEEPLE ST STE 202-37
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3287
Practice Address - Country:US
Practice Address - Phone:508-375-7936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty