Doctor Name: | MR. DINA D WAVEZWA |
NPI Number: | 1114224003 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 110 Boston St Salem, MA - 019701402 |
Business Phone Number: | 9782191525 |
Business Fax Number: | 9787409145 |
Mailing Address: | 110 Boston St, SALEM |
State: | MA |
Postal Code: | 019701402 |
Phone Number: | 9782191525 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2011 |
NPI Last Update Date: | 02/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |