Healthcare Provider Details

I. General information

NPI: 1063636975
Provider Name (Legal Business Name): BEATRICE ESCOBAR M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 COURT ST SUITE 102
PLYMOUTH MA
02360-7304
US

IV. Provider business mailing address

215 COMMON ST UNIT 3
QUINCY MA
02169-4757
US

V. Phone/Fax

Practice location:
  • Phone: 508-830-3444
  • Fax:
Mailing address:
  • Phone: 508-830-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: