Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | 215878 | MA |
NPI | 1003075102 |
---|---|
Provider Name | Tatiana Schettini |
First Address | Somerville, MA 02143-3421 |
Second Address | Somerville, MA 02143-3421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 11/11/2009 |