Provider Demographics
NPI:1508375056
Name:VELONA, BETTINA
Entity Type:Individual
Prefix:MS
First Name:BETTINA
Middle Name:
Last Name:VELONA
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 1:872 MASSACHUSETTS AVE STE 2-1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3072
Mailing Address - Country:US
Mailing Address - Phone:781-277-3015
Mailing Address - Fax:
Practice Address - Street 1:872 MASSACHUSETTS AVE STE 2-1
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3072
Practice Address - Country:US
Practice Address - Phone:781-641-7478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health