Provider Demographics
NPI:1023363355
Name:AQUINO, DANUZA (MED)
Entity Type:Individual
Prefix:
First Name:DANUZA
Middle Name:
Last Name:AQUINO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:DANUZA
Other - Middle Name:MARTINS AQUINO
Other - Last Name:WESTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19 BOSTON ST # 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2005
Mailing Address - Country:US
Mailing Address - Phone:617-818-1102
Mailing Address - Fax:
Practice Address - Street 1:19 BOSTON ST # 2
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-2005
Practice Address - Country:US
Practice Address - Phone:617-818-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist