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1902399090
MIRIAM BETH SHABAZZ
JAMAICA PLAIN, MA
NPI
1902399090
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MA 000121255)
Enumeration Date
2018-06-13
Last Update Date
2018-06-13
Business Address
MIRIAM BETH SHABAZZ LICSW
150 S HUNTINGTON AVE
JAMAICA PLAIN, MA 02130-4817
Phone number: 857-364-6311
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Mailing Address
MIRIAM BETH SHABAZZ LICSW
150 S HUNTINGTON AVE 116B MENTAL HEALTH SERVICE
JAMAICA PLAIN, MA 02130-4817
Phone number: 857-364-6311
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