Individual
MR. MENDRICK BANZUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
484 MAIN ST, WORCESTER, MA 01608-1893
(508) 791-4373
Mailing address
484 MAIN ST, WORCESTER, MA 01608-1893
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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