Provider Demographics
NPI:1942637467
Name:HIDALGO, ANA T
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:T
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANA
Other - Middle Name:T
Other - Last Name:AYOBIOJO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3504
Mailing Address - Country:US
Mailing Address - Phone:617-676-5911
Mailing Address - Fax:
Practice Address - Street 1:14 BIRCH ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3504
Practice Address - Country:US
Practice Address - Phone:617-676-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-28
Last Update Date:2013-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health