Doctor Name: | MARIA LEITAO |
NPI Number: | 1023473147 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 220429 |
Business Practice Address: | 103 Commercial St Brockton, MA - 023023101 |
Business Phone Number: | 5085804691 |
Business Fax Number: | 5085885980 |
Mailing Address: | 1651 Liberty St, BRAINTREE |
State: | MA |
Postal Code: | 021848274 |
Phone Number: | 5085804691 |
Fax Number: | 5085885980 |
NPI Enumeration Date: | 12/16/2015 |
NPI Last Update Date: | 12/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 220429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |