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Individual
ANTONE D TAVEIRA
Active
Individual
ANTONE D TAVEIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1186
MA
164X00000X
Licensed Vocational Nurse
30347
MA
225C00000X
Rehabilitation Counselor
706
MA
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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