Provider Demographics
NPI:1255873733
Name:VILLAFANE, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:VILLAFANE
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 1:23 MCDONOUGH WAY
Mailing Address - Street 2:APT 691
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3718
Mailing Address - Country:US
Mailing Address - Phone:857-257-0253
Mailing Address - Fax:
Practice Address - Street 1:23 MCDONOUGH WAY
Practice Address - Street 2:691
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127
Practice Address - Country:US
Practice Address - Phone:857-257-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker