Provider Demographics
NPI:1578031696
Name:CORDEIRO BARTOLINI, EDILAINE WULFILA (BACHELOR DEGREE)
Entity Type:Individual
Prefix:MRS
First Name:EDILAINE WULFILA
Middle Name:
Last Name:CORDEIRO BARTOLINI
Suffix:
Gender:F
Credentials:BACHELOR DEGREE
Other - Prefix:MISS
Other - First Name:EDILAINE WULFILA
Other - Middle Name:
Other - Last Name:CORDEIRO LIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:8A MAPLE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01745-1011
Mailing Address - Country:US
Mailing Address - Phone:508-596-8781
Mailing Address - Fax:
Practice Address - Street 1:340 MAPLE ST STE 410
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3200
Practice Address - Country:US
Practice Address - Phone:508-624-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist