Provider Demographics
NPI:1912500372
Name:DEVANE, RASHIDAH AMIRAH
Entity Type:Individual
Prefix:
First Name:RASHIDAH
Middle Name:AMIRAH
Last Name:DEVANE
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 1:208 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3767
Mailing Address - Country:US
Mailing Address - Phone:978-632-0934
Mailing Address - Fax:
Practice Address - Street 1:40 CEDAR ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1606
Practice Address - Country:US
Practice Address - Phone:978-632-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)