Provider Demographics
NPI:1730681081
Name:GIACOMINI, TAINARA GOMES
Entity type:Individual
Prefix:
First Name:TAINARA
Middle Name:GOMES
Last Name:GIACOMINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAINARA
Other - Middle Name:GOMES
Other - Last Name:GIACOMINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-3006
Mailing Address - Country:US
Mailing Address - Phone:617-771-9904
Mailing Address - Fax:
Practice Address - Street 1:14 FORDHAM RD
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3006
Practice Address - Country:US
Practice Address - Phone:617-771-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor