Provider Demographics
NPI:1912357997
Name:ESTEVEZ, ESTHEPHANNIE MARIA
Entity Type:Individual
Prefix:MS
First Name:ESTHEPHANNIE
Middle Name:MARIA
Last Name:ESTEVEZ
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 1:17 TENNEY ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2423
Mailing Address - Country:US
Mailing Address - Phone:978-601-2821
Mailing Address - Fax:
Practice Address - Street 1:17 TENNEY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2423
Practice Address - Country:US
Practice Address - Phone:978-601-2821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor