Provider Demographics
NPI:1366626947
Name:CORDEIRO, CHRISTINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:CORDEIRO
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 1:1020 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-1843
Mailing Address - Country:US
Mailing Address - Phone:508-822-3213
Mailing Address - Fax:508-822-5363
Practice Address - Street 1:30 LUSCOMB RD
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-4704
Practice Address - Country:US
Practice Address - Phone:508-822-3213
Practice Address - Fax:508-822-5363
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical