Provider Demographics
NPI:1104026749
Name:SOUZA, DOREEN GERMAINE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:GERMAINE
Last Name:SOUZA
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 1:84 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1807
Mailing Address - Country:US
Mailing Address - Phone:508-998-7238
Mailing Address - Fax:508-584-4328
Practice Address - Street 1:15 BOLTON PL
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5316
Practice Address - Country:US
Practice Address - Phone:508-427-4383
Practice Address - Fax:508-584-4328
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical