Provider Demographics
NPI:1467874396
Name:COMPERE, HUBERTE
Entity Type:Individual
Prefix:MS
First Name:HUBERTE
Middle Name:
Last Name:COMPERE
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 FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3006
Mailing Address - Country:US
Mailing Address - Phone:617-782-6460
Mailing Address - Fax:617-782-6444
Practice Address - Street 1:14 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3104
Practice Address - Country:US
Practice Address - Phone:617-782-6460
Practice Address - Fax:617-782-6444
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1467874396103TM1800X, 172V00000X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No172V00000XOther Service ProvidersCommunity Health Worker
No251B00000XAgenciesCase Management