Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 104100000X | Social Worker |
NPI | 1003325226 |
---|---|
Provider Name | Mrs. Daniela Noemi Thermora |
First Address | Waltham, MA 02453-5218 |
Second Address | Waltham, MA 02453-5476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 20/09/2017 |