Individual
TIANA BADOLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 PLEASANT ST, LYNN, MA 01901-1524
(781) 581-4493
Mailing address
122 KEAYNE ST, REVERE, MA 02151-1822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/22/2011
Last updated
08/18/2016
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