Individual
SAMUEL ALVES FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
150 S HUNTINGTON AVE, BOSTON, MA 02130-4817
(857) 345-5660
Mailing address
8 CODMAN ST, DORCHESTER, MA 02124-4614
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
228672
MA
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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