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General NPI Number Information
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NPI Number | 1225717051
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Entity Type | Individual
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Provider Name | AUTUMN VENABLE MSW
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Gender | Female
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 88 LINCOLN ST
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City | FRAMINGHAM
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State | MA
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Zip | 01702-6354
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Country | US
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Telephone | 508-469-3290
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Fax |
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Provider Business Mailing Address
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Address Line | 131 LITCHFIELD PINES DR APT D
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City | LEOMINSTER
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State | MA
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Zip | 01453-5883
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Country | US
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Telephone | 617-513-0560
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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