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General NPI Number Information
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NPI Number | 1306662879
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Entity Type | Individual
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Provider Name | EIMY CHANOA CARELA URBAEZ
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Gender | Female
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 263 EUSTIS ST
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City | ROXBURY
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State | MA
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Zip | 02119-2826
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Country | US
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Telephone | 617-913-8453
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Fax |
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Provider Business Mailing Address
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Address Line | 211 PARK DR
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City | BOSTON
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State | MA
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Zip | 02215-4742
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Country | US
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Telephone | 978-983-7991
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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 |
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License Number State | MA
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