Doctor Name: | MS. LISA RUKHSANA AHMED |
NPI Number: | 1295710549 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LICSW |
License Number: | 1027724 |
Business Practice Address: | 841 Main Street, Ll2 Colony Care Behavioral Health Walpole, MA - 02081 |
Business Phone Number: | 5086606699 |
Business Fax Number: | 5086606658 |
Mailing Address: | 841 Main St, Ll2 WALPOLE |
State: | MA |
Postal Code: | 020812997 |
Phone Number: | 5086606699 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1027724 |
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 |