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1306915061
RICHARD JOHN DOMENICO
BOSTON, MA
NPI
1306915061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MA 1027486)
Enumeration Date
2006-11-07
Last Update Date
2007-07-08
Business Address
Mr. RICHARD JOHN DOMENICO LICSW
607 BOYLSTON ST FL 2
BOSTON, MA 02116-3604
Phone number: 617-266-2266
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Mailing Address
Mr. RICHARD JOHN DOMENICO LICSW
607 BOYLSTON ST FL 2
BOSTON, MA 02116-3604
Phone number: 617-266-2266
Copy
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