Provider Demographics
NPI:1578147757
Name:AQUINO, EUDANIA
Entity Type:Individual
Prefix:
First Name:EUDANIA
Middle Name:
Last Name:AQUINO
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 1:149 BERKELEY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-1255
Mailing Address - Country:US
Mailing Address - Phone:978-852-8393
Mailing Address - Fax:
Practice Address - Street 1:149 BERKELEY ST APT 2
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-1255
Practice Address - Country:US
Practice Address - Phone:978-852-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician