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General NPI Number Information
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NPI Number | 1124611199
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Entity Type | Individual
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Provider Name | XIMENA CASTELAZO SOTO MSW
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Gender | Female
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Dates
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Enumeration Date | 02/19/2021
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 140 COMMONWEALTH AVE
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-3858
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Country | US
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Telephone | 617-552-0776
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Fax |
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Provider Business Mailing Address
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Address Line | 7 GARRISON RD
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City | BELMONT
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State | MA
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Zip | 02478-4606
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Country | US
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Telephone | 617-877-6370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1100329
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License Number State | MA
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