Provider Demographics
NPI:1013638527
Name:DE ASSIS, CAMILA GONCALVES
Entity type:Individual
Prefix:MRS
First Name:CAMILA
Middle Name:GONCALVES
Last Name:DE ASSIS
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 1:261 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1412
Mailing Address - Country:US
Mailing Address - Phone:508-663-6580
Mailing Address - Fax:
Practice Address - Street 1:261 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPEDALE
Practice Address - State:MA
Practice Address - Zip Code:01747-1412
Practice Address - Country:US
Practice Address - Phone:508-663-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician