Provider Demographics
NPI:1821226382
Name:DEL RE, ELISABETTA C (MA)
Entity Type:Individual
Prefix:DR
First Name:ELISABETTA
Middle Name:C
Last Name:DEL RE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SEARLE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-6805
Mailing Address - Country:US
Mailing Address - Phone:617-731-0067
Mailing Address - Fax:
Practice Address - Street 1:3 SEARLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6805
Practice Address - Country:US
Practice Address - Phone:617-731-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst