Provider Demographics
NPI:1649479445
Name:CINELLI, DIANA MORA
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MORA
Last Name:CINELLI
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 1:301 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-2807
Mailing Address - Country:US
Mailing Address - Phone:617-569-9450
Mailing Address - Fax:617-569-3516
Practice Address - Street 1:301 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2807
Practice Address - Country:US
Practice Address - Phone:617-569-9450
Practice Address - Fax:617-569-3516
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA7763235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor