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1558878264
TAVERLY JUDE SOUSA
BROOKLINE, MA
NPI
1558878264
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MA 106122)
Enumeration Date
2018-01-03
Last Update Date
2018-01-03
Business Address
TAVERLY JUDE SOUSA LICSW
33 POND AVE # B207
BROOKLINE, MA 02445-7163
Phone number: 617-739-0075
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Mailing Address
TAVERLY JUDE SOUSA LICSW
33 POND AVE # B207
BROOKLINE, MA 02445-7163
Phone number: 617-739-0075
Copy
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