Individual
ALI WANTIMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(781) 885-4264
Mailing address
504 DUDLEY ST, ROXBURY, MA 02119-2732
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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