Provider Information for 1326181595
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Mr. ROBERT C. ANZOLA MSW, LICSW
Sex: Male
NPI: 1326181595
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1326181595 | ||||||||
| Enumeration Date | 2007-02-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 980 MAIN ST UNIT B OSTERVILLE, MA 02655-2045 United States Phone: 508-732-3000 | Fax:508-746-3224 | ||||||||
| Primary Practice Address | 40 INDUSTRIAL PARK RD D.M.H. PLYMOUTH, MA 02360-4884 United States Phone: 508-732-3000 | Fax:508-746-3224 | ||||||||
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