Individual
DIBEL PRIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 445-1123
Mailing address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 445-1123
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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