Provider Demographics
NPI:1952892952
Name:SEBASTINO, ANNAMARIA
Entity Type:Individual
Prefix:
First Name:ANNAMARIA
Middle Name:
Last Name:SEBASTINO
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 1:153 1/2 STATE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3946
Mailing Address - Country:US
Mailing Address - Phone:520-332-4935
Mailing Address - Fax:
Practice Address - Street 1:153 1/2 STATE ST APT 4
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3946
Practice Address - Country:US
Practice Address - Phone:520-332-4935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician