Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 6892 | MA |
NPI | 1003168725 |
---|---|
Provider Name | Ms. Joanne Tsakas Barros |
First Address | Arlington, MA 02476-4784 |
Second Address | Arlington, MA 02476-4784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2012 |
Last Update Date | 04/10/2012 |