Most Relevant Information
Provider Data
| NPI Number: | 1003236605 |
| Provider Name: | MANUEL DE PENA |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/22/2014 |
| Last Updated: | 04/22/2014 |
Provider Practice Location
301 BROADWAY
CHELSEA
MA
021502807
Practice Location Phone/Fax
| Phone: | 6179727914 |
| Fax: |
Provider Mailing Location
301 BROADWAY
CHELSEA
MA
021502807
Provider Mailing Phone/Fax
| Phone: | 6179727914 |
| Fax: |