Individual
MS. FILOMENA DACRUZ DAVEIGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC II
Contact information
Practice address
76 COOLIDGE AVE, BROCKTON, MA 02302-3356
(774) 297-0735
Mailing address
76 COOLIDGE AVE, BROCKTON, MA 02302-3356
(774) 297-0735
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2387
MA
101YA0400X
Addiction (Substance Use Disorder) Counselor
2387
MA
101YM0800X
Mental Health Counselor
2387
MA
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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