Provider Demographics
NPI:1649455049
Name:SOUZA, LUANA JEANNE (MA CEIS DS)
Entity type:Individual
Prefix:
First Name:LUANA
Middle Name:JEANNE
Last Name:SOUZA
Suffix:
Gender:F
Credentials:MA CEIS DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720
Mailing Address - Country:US
Mailing Address - Phone:508-675-5778
Mailing Address - Fax:508-672-6024
Practice Address - Street 1:636 ROCK ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720
Practice Address - Country:US
Practice Address - Phone:508-675-5778
Practice Address - Fax:508-672-6024
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor