Provider Demographics
NPI:1740387794
Name:FERRERA, COLLEEN D (MA)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:D
Last Name:FERRERA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:D
Other - Last Name:STREETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:10 PARKER ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3866
Mailing Address - Country:US
Mailing Address - Phone:978-630-4740
Mailing Address - Fax:
Practice Address - Street 1:10 PARKER ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3866
Practice Address - Country:US
Practice Address - Phone:978-630-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health