Provider Demographics
NPI:1144616293
Name:FILOMENO, IRIS
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:FILOMENO
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 1:14 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-5605
Mailing Address - Country:US
Mailing Address - Phone:978-457-0078
Mailing Address - Fax:
Practice Address - Street 1:14 GRANITE ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-5605
Practice Address - Country:US
Practice Address - Phone:978-457-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor