Provider Demographics
NPI:1366840803
Name:VARGAS, MABEL
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:VARGAS
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 1:1059 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2149
Mailing Address - Country:US
Mailing Address - Phone:978-686-8980
Mailing Address - Fax:978-686-0400
Practice Address - Street 1:248 BROADWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1052
Practice Address - Country:US
Practice Address - Phone:978-686-8980
Practice Address - Fax:978-686-0400
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker