Provider Demographics
NPI:1255521886
Name:STRAUSS, ADELE HELENE (MAC LIC AC)
Entity type:Individual
Prefix:MS
First Name:ADELE
Middle Name:HELENE
Last Name:STRAUSS
Suffix:
Gender:F
Credentials:MAC LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2622
Mailing Address - Country:US
Mailing Address - Phone:617-779-9979
Mailing Address - Fax:617-789-4142
Practice Address - Street 1:56 BENNETT ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2622
Practice Address - Country:US
Practice Address - Phone:617-779-9979
Practice Address - Fax:617-789-4142
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist