Provider Demographics
NPI:1740584499
Name:SUZUKI-DIAZ, TOSHIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:TOSHIE
Middle Name:
Last Name:SUZUKI-DIAZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:TOSHIE
Other - Middle Name:
Other - Last Name:SUZUKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:86 NEWBURY ST
Mailing Address - Street 2:7
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2439
Mailing Address - Country:US
Mailing Address - Phone:224-430-1468
Mailing Address - Fax:
Practice Address - Street 1:25 STANIFORD ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2503
Practice Address - Country:US
Practice Address - Phone:617-912-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1151161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical