Provider Demographics
NPI:1033362983
Name:PORTO, ESMERALDA (MSW)
Entity Type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:
Last Name:PORTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 KENNEDY DR APT 211
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3317
Mailing Address - Country:US
Mailing Address - Phone:978-807-5797
Mailing Address - Fax:
Practice Address - Street 1:250 KENNEDY DR APT 211
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-3317
Practice Address - Country:US
Practice Address - Phone:978-807-5797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical