Provider Demographics
NPI:1043090228
Name:LONDONO, DANIELA ANDREA
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:ANDREA
Last Name:LONDONO
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 1:625 MAIN ST FL 3
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-3496
Mailing Address - Country:US
Mailing Address - Phone:413-650-6701
Mailing Address - Fax:978-342-1631
Practice Address - Street 1:76 ASH ST BSMT
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2150
Practice Address - Country:US
Practice Address - Phone:321-301-9154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor