Provider Demographics
NPI:1629746979
Name:VIERA, DENIA M
Entity Type:Individual
Prefix:
First Name:DENIA
Middle Name:M
Last Name:VIERA
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 1:56 STONEBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-2019
Mailing Address - Country:US
Mailing Address - Phone:781-424-3205
Mailing Address - Fax:
Practice Address - Street 1:117 ELM ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-6466
Practice Address - Country:US
Practice Address - Phone:603-966-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH138992103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH138992OtherBEGINNING EDUCATOR LICENSE