Basic Information
| Provider Information | |||||||||
| NPI: | 1548690043 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUARD | ||||||||
| FirstName: | CECILIA | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ALBUQUERQUE | ||||||||
| OtherFirstName: | CECILIA | ||||||||
| OtherMiddleName: | MARIA | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 43 TUPELO RD | ||||||||
| Address2: | |||||||||
| City: | WESTPORT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027904981 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089655069 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 400 WASHINGTON ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | BRAINTREE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021844729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818433683 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2013 | ||||||||
| LastUpdateDate: | 11/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 101Y00000 | MA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.