RAQUEL MELYSSA PROVDA

LYNN, MA
NPI1174888911
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MA  LICSW1120818)
Enumeration Date2012-07-09
Last Update Date2024-12-04
Business Address
RAQUEL MELYSSA PROVDA LICSW
11 CIRCLE AVE
LYNN, MA 01905-3050
Phone number: 781-595-2413
Mailing Address
RAQUEL MELYSSA PROVDA LICSW
11 CIRCLE AVE
LYNN, MA 01905-3050
Phone number: 781-595-2413