Individual
BRENDA SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC, LADCI
Contact information
Practice address
497 BELLEVILLE AVE, NEW BEDFORD, MA 02746-2420
(508) 991-7487
Mailing address
497 BELLEVILLE AVE, NEW BEDFORD, MA 02746-2420
(508) 991-7487
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1418
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1894234
—
MA
Enumeration date
12/04/2007
Last updated
12/04/2007
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