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NPI Code Detail

MEDICARE: LAILA EVA BIGONET LISCW

MEDICARE:   LAILA EVA  BIGONET  LISCW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
21041C0700XClinical Social Worker117935MA

General Provider Information

NPI Number : 1952610081
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAILA EVA BIGONET LISCW
Provider Business Mailing Address
First Line : 263 WASHINGTON ST STE 1
Second Line :
City : WELLESLEY HILLS
State : MA
Zip : 02481-3141
Country : US
Telephone Number : 617-480-5683
Fax Number : 781-235-1433
Provider Business Practice Location Address
First Line : 263 WASHINGTON ST STE 1
Second Line :
City : WELLESLEY HILLS
State : MA
Zip : 02481-3141
Country : US
Telephone Number : 617-480-5683
Fax Number : 781-235-1433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2010
Last Update Date : 11/20/2015

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Directions to “ LAILA EVA BIGONET LISCW” Practice Location

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