Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 301522 | MA |
NPI | 1003097759 |
---|---|
Provider Name | Ms. Socorro Ching |
First Address | Medford, MA 02155-1532 |
Second Address | Medford, MA 02155-1532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2007 |
Last Update Date | 23/11/2007 |