Provider Demographics
NPI:1952050239
Name:ARIAS, JULISSA ESMERALDA
Entity Type:Individual
Prefix:
First Name:JULISSA
Middle Name:ESMERALDA
Last Name:ARIAS
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 1:184 SPRINGVALE AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-5425
Mailing Address - Country:US
Mailing Address - Phone:617-867-5057
Mailing Address - Fax:
Practice Address - Street 1:500 W CUMMINGS PARK STE 1800
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6506
Practice Address - Country:US
Practice Address - Phone:339-227-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician