Provider Demographics
NPI:1326528043
Name:SEQUEIRA, DALILA MARIA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DALILA
Middle Name:MARIA
Last Name:SEQUEIRA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 GARLAND DR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3578
Mailing Address - Country:US
Mailing Address - Phone:978-852-1080
Mailing Address - Fax:
Practice Address - Street 1:209 GARLAND DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-3578
Practice Address - Country:US
Practice Address - Phone:978-852-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical