Provider Demographics
NPI:1225309578
Name:MERON, DAFNAH TSOFIA
Entity Type:Individual
Prefix:
First Name:DAFNAH
Middle Name:TSOFIA
Last Name:MERON
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 1:104 MATHEWS RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341-9793
Mailing Address - Country:US
Mailing Address - Phone:201-738-0261
Mailing Address - Fax:
Practice Address - Street 1:150 LOWER WESTFIELD RD STE 1
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2676
Practice Address - Country:US
Practice Address - Phone:201-738-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099242621041C0700X
MALICSW1242071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical