Healthcare Provider Details

I. General information

NPI: 1710665831
Provider Name (Legal Business Name): MANUELA ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1452 DORCHESTER AVE
BOSTON MA
02122-1386
US

IV. Provider business mailing address

35 WEBSTER CT
AMHERST MA
01002-2833
US

V. Phone/Fax

Practice location:
  • Phone: 781-817-3956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2130270
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: