Provider Demographics
NPI:1568790087
Name:SHEA FRAIZE, DINA M (BEHAVIORAL HEALTH)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:M
Last Name:SHEA FRAIZE
Suffix:
Gender:F
Credentials:BEHAVIORAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FARM HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1450
Mailing Address - Country:US
Mailing Address - Phone:508-868-7489
Mailing Address - Fax:
Practice Address - Street 1:3 FARM HOUSE RD
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1450
Practice Address - Country:US
Practice Address - Phone:508-868-7489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical