Provider Demographics
NPI:1063870335
Name:TOSO, VANDERLEIA
Entity type:Individual
Prefix:
First Name:VANDERLEIA
Middle Name:
Last Name:TOSO
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 1:30 HENRY ST APT 4
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6656
Mailing Address - Country:US
Mailing Address - Phone:857-998-1237
Mailing Address - Fax:
Practice Address - Street 1:30 HENRY ST APT 4
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6656
Practice Address - Country:US
Practice Address - Phone:857-998-1237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health