Provider Demographics
NPI:1841674447
Name:ALBOSTA, MERRA (MA)
Entity type:Individual
Prefix:
First Name:MERRA
Middle Name:
Last Name:ALBOSTA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MILL ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54966-8918
Mailing Address - Country:US
Mailing Address - Phone:715-513-6484
Mailing Address - Fax:
Practice Address - Street 1:117 MILL ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:WI
Practice Address - Zip Code:54966-8918
Practice Address - Country:US
Practice Address - Phone:715-513-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health