Individual
DANIELLE M PROVIDAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
399 REVOLUTION DR, SOMERVILLE, MA 02145-1484
(800) 856-1983
Mailing address
399 REVOLUTION DR, SOMERVILLE, MA 02145-1484
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9335
MA
Other
Enumeration date
09/14/2011
Last updated
06/12/2025
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