Provider Demographics
NPI:1710545462
Name:CORTEZ, DAMARIS JANEXIS
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:JANEXIS
Last Name:CORTEZ
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 1:10 GUEST ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2066
Mailing Address - Country:US
Mailing Address - Phone:617-267-3700
Mailing Address - Fax:
Practice Address - Street 1:202 W SELDEN ST # 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02126-2324
Practice Address - Country:US
Practice Address - Phone:617-708-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker