Provider Demographics
NPI:1891412763
Name:INNER YOU OF MASSACHUSETTS
Entity Type:Organization
Organization Name:INNER YOU OF MASSACHUSETTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOWBRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-391-5489
Mailing Address - Street 1:2184 PLAINFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-2012
Mailing Address - Country:US
Mailing Address - Phone:401-391-5489
Mailing Address - Fax:
Practice Address - Street 1:1547 FALL RIVER AVE # 2A
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-3744
Practice Address - Country:US
Practice Address - Phone:401-391-5489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty