Healthcare Provider Details

I. General information

NPI: 1073705927
Provider Name (Legal Business Name): CHRISTOPHER RICHARD MAROBELLA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 GREAT RD
ACTON MA
01720-3415
US

IV. Provider business mailing address

15 GLEZEN LN
WAYLAND MA
01778-1601
US

V. Phone/Fax

Practice location:
  • Phone: 978-263-0439
  • Fax: 978-263-5706
Mailing address:
  • Phone: 508-494-3017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: