Basic Information
| Provider Information | |||||||||
| NPI: | 1649479445 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CINELLI | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | MORA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021502807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175699450 | ||||||||
| FaxNumber: | 6175693516 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021502807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175699450 | ||||||||
| FaxNumber: | 6175693516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 03/11/2010 | ||||||||
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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 | N | Behavioral Health & Social Service Providers | Counselor | 235Z00000X | 7763 | MA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.