Provider Demographics
NPI:1649802596
Name:CASIMIR, LOVELY
Entity type:Individual
Prefix:
First Name:LOVELY
Middle Name:
Last Name:CASIMIR
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 1:12B GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-3719
Mailing Address - Country:US
Mailing Address - Phone:857-333-2537
Mailing Address - Fax:
Practice Address - Street 1:132 ROBBS HILL RD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-2167
Practice Address - Country:US
Practice Address - Phone:978-696-7401
Practice Address - Fax:508-861-0206
Is Sole Proprietor?:No
Enumeration Date:2020-02-09
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician