Provider Demographics
NPI:1912529355
Name:EMOTIONAL STEP UP HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:EMOTIONAL STEP UP HEALTH SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WANDERI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:978-735-4640
Mailing Address - Street 1:517 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-3826
Mailing Address - Country:US
Mailing Address - Phone:978-735-4640
Mailing Address - Fax:978-735-4639
Practice Address - Street 1:517 ROGERS ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-3826
Practice Address - Country:US
Practice Address - Phone:978-735-4640
Practice Address - Fax:978-735-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty