Individual
CHANTILLY WIJAYASINHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 SOUTH ST, SOMERVILLE, MA 02143-4297
(281) 222-2154
Mailing address
19 MELVIN AVE, # 15, BRIGHTON, MA 02135-7440
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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