Healthcare Provider Details

I. General information

NPI: 1699043877
Provider Name (Legal Business Name): ALMA KOBACIC LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 07/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PLEASANT ST SUITE 220
MALDEN MA
02148-5100
US

IV. Provider business mailing address

6 PLEASANT ST SUITE 220
MALDEN MA
02148-5100
US

V. Phone/Fax

Practice location:
  • Phone: 781-338-2640
  • Fax: 781-338-2217
Mailing address:
  • Phone: 781-338-2640
  • Fax: 781-338-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: