Basic Information
| Provider Information | |||||||||
| NPI: | 1124758016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEJANDRO | ||||||||
| FirstName: | MAHLY | ||||||||
| MiddleName: | ENID | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 296 OAK ST # 2 | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015103116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089337970 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1881 WORCESTER RD | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017015410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086286300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2022 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.