Provider Demographics
NPI:1508027061
Name:FUENTES DUARTE-HAIRSTON, DAWN A (MS, MED)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:A
Last Name:FUENTES DUARTE-HAIRSTON
Suffix:
Gender:F
Credentials:MS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 PARK ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2023
Mailing Address - Country:US
Mailing Address - Phone:617-825-4476
Mailing Address - Fax:
Practice Address - Street 1:537 PARK ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2023
Practice Address - Country:US
Practice Address - Phone:617-825-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor