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Individual

DENISE MARIE FANEUFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
45 STERLING ST # 25A, WEST BOYLSTON, MA 01583-1200
(508) 335-8364
Mailing address
45 STERLING ST # 25A, WEST BOYLSTON, MA 01583-1200
(508) 335-8364

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5968
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11717976
CAQH
MA
Enumeration date
05/01/2007
Last updated
08/11/2023
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