Provider Demographics
NPI:1033873641
Name:URENA QUEZADA, AURA MARIEL
Entity Type:Individual
Prefix:
First Name:AURA
Middle Name:MARIEL
Last Name:URENA QUEZADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 NORMAN ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-5003
Mailing Address - Country:US
Mailing Address - Phone:413-296-6185
Mailing Address - Fax:413-732-5362
Practice Address - Street 1:376 NASH RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-1827
Practice Address - Country:US
Practice Address - Phone:774-406-4620
Practice Address - Fax:413-732-5362
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor