Provider Demographics
NPI:1346770922
Name:RAOUI, SALWA V (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SALWA
Middle Name:V
Last Name:RAOUI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LINCOLN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3033
Mailing Address - Country:US
Mailing Address - Phone:781-600-2315
Mailing Address - Fax:
Practice Address - Street 1:7 LINCOLN ST STE 201
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3033
Practice Address - Country:US
Practice Address - Phone:781-600-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2328758363LP0808X
NY725411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse