Individual
LATEASE ALEXIS GUILDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
56 HAMILTON ST, HYDE PARK, MA 02136-2318
(617) 953-4395
Mailing address
56 HAMILTON ST, HYDE PARK, MA 02136-2318
(617) 953-4395
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
226835
MA
Other
Enumeration date
05/30/2021
Last updated
05/30/2021
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