Healthcare Provider Details

I. General information

NPI: 1881149342
Provider Name (Legal Business Name): RENEE M ESPINOLA LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SUMMER ST
CHELMSFORD MA
01824-3076
US

IV. Provider business mailing address

7 SUMMER ST
CHELMSFORD MA
01824-3076
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-1444
  • Fax:
Mailing address:
  • Phone: 978-256-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 119045-1
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: