Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 313718 | MA |
NPI | 1003283664 |
---|---|
Provider Name | Christina Maria Conforto |
First Address | Medford, MA 02155-6029 |
Second Address | Medford, MA 02155-6029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2015 |
Last Update Date | 28/08/2015 |