Individual
GINA DAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-0794
Mailing address
300 LONGWOOD AVE FL 6, BOSTON, MA 02115-5724
(617) 355-0794
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
225446
MA
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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