Individual
IZADORA THAMIE THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N MAIN ST, RANDOLPH, MA 02368-4177
(781) 885-0277
Mailing address
79 KENNEDY RD, STOUGHTON, MA 02072-3814
(401) 422-9717
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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