Healthcare Provider Details

I. General information

NPI: 1033734199
Provider Name (Legal Business Name): KOLBY ROSE ANDRADE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2020
Last Update Date: 06/14/2020
Certification Date: 06/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N FRONT ST
NEW BEDFORD MA
02740-7327
US

IV. Provider business mailing address

313 S BEACON ST APT 2
FALL RIVER MA
02724-1579
US

V. Phone/Fax

Practice location:
  • Phone: 774-628-1000
  • Fax:
Mailing address:
  • Phone: 774-322-5159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: