Individual
MALIDA THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
57 OSCAR AVE, BROCKTON, MA 02302-1047
(617) 283-6211
Mailing address
623 CENTRE ST, BROCKTON, MA 02302-3307
(617) 283-6211
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/31/2016
Last updated
08/05/2024
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