Provider Demographics
NPI:1649552282
Name:ACEVEDO, EMILYS
Entity type:Individual
Prefix:
First Name:EMILYS
Middle Name:
Last Name:ACEVEDO
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 1:261 OCALLAGHAN WAY
Mailing Address - Street 2:821
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3619
Mailing Address - Country:US
Mailing Address - Phone:617-697-8344
Mailing Address - Fax:
Practice Address - Street 1:261 OCALLAGHAN WAY
Practice Address - Street 2:821
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3619
Practice Address - Country:US
Practice Address - Phone:617-697-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker