Provider Demographics
NPI:1477890499
Name:DEPINA, RITA GOMES
Entity Type:Individual
Prefix:MISS
First Name:RITA
Middle Name:GOMES
Last Name:DEPINA
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 1:5 CANTON ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-1744
Mailing Address - Country:US
Mailing Address - Phone:857-928-1084
Mailing Address - Fax:
Practice Address - Street 1:5 CANTON ST APT 2F
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-1744
Practice Address - Country:US
Practice Address - Phone:857-928-1084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health