Individual
MS. KIMBERLY DAWN DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 WASHINGTON ST, TAUNTON, MA 02780-3960
(508) 823-5400
Mailing address
124 ALDANA RD, HALIFAX, MA 02338-1047
(774) 259-6363
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
214776
MA
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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