Provider Demographics
NPI:1821871344
Name:SOSA, TREANALISE JASMINE
Entity Type:Individual
Prefix:
First Name:TREANALISE
Middle Name:JASMINE
Last Name:SOSA
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 1:91 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-4725
Mailing Address - Country:US
Mailing Address - Phone:781-691-7060
Mailing Address - Fax:781-691-7064
Practice Address - Street 1:91 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4725
Practice Address - Country:US
Practice Address - Phone:781-691-7060
Practice Address - Fax:781-691-7064
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker