Individual
ARIEL DANCE GREENIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
10 CABOT RD, MEDFORD, MA 02155-5177
(617) 308-9229
Mailing address
PO BOX 440433, SOMERVILLE, MA 02144-0006
(617) 308-9229
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
111516
MA
Other
Enumeration date
09/22/2007
Last updated
09/22/2007
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