Provider Demographics
NPI:1518653054
Name:ADORNO, THERESA ROSE (MED)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ROSE
Last Name:ADORNO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:ROSE
Other - Last Name:ADORNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:7 MISCOE RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3532
Mailing Address - Country:US
Mailing Address - Phone:508-904-9484
Mailing Address - Fax:
Practice Address - Street 1:7 MISCOE RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-3532
Practice Address - Country:US
Practice Address - Phone:508-904-9484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health