Provider Demographics
NPI:1457103368
Name:ISHIMWE MARIZA, CLARISSE (MSW)
Entity Type:Individual
Prefix:
First Name:CLARISSE
Middle Name:
Last Name:ISHIMWE MARIZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1398
Mailing Address - Country:US
Mailing Address - Phone:978-968-1700
Mailing Address - Fax:
Practice Address - Street 1:148 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2523
Practice Address - Country:US
Practice Address - Phone:781-453-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker