Individual
TIA SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 BROADWAY UNIT 45165, SOMERVILLE, MA 02145-4507
(781) 535-4877
Mailing address
320 BROADWAY UNIT 45165, SOMERVILLE, MA 02145-4507
(781) 535-4877
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19531934
MA
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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