Provider Demographics
NPI:1003325226
Name:THERMORA, DANIELA NOEMI (MED)
Entity Type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:NOEMI
Last Name:THERMORA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HALL ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5218
Mailing Address - Country:US
Mailing Address - Phone:781-330-6774
Mailing Address - Fax:
Practice Address - Street 1:431 RIVER ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5476
Practice Address - Country:US
Practice Address - Phone:781-891-0556
Practice Address - Fax:781-647-1432
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker