Provider Demographics
NPI:1093942732
Name:ANZALOTA, JANINE (MSW, LICSW, MPH)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:ANZALOTA
Suffix:
Gender:F
Credentials:MSW, LICSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 ROSLINDALE AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2906
Mailing Address - Country:US
Mailing Address - Phone:978-885-0516
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1139631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical