Individual
MRS. GILIANA BOLENA TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
145 FAUNCE CORNER RD STE K, NORTH DARTMOUTH, MA 02747-1263
(774) 206-1125
Mailing address
42 BOURNE ST, BROCKTON, MA 02302-1431
(508) 580-4453
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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