Provider Demographics
NPI:1730964461
Name:MALAVE-TOMEI, SELIMAR
Entity type:Individual
Prefix:
First Name:SELIMAR
Middle Name:
Last Name:MALAVE-TOMEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SELI
Other - Middle Name:
Other - Last Name:MALAVE-TOMEI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:111 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1151
Mailing Address - Country:US
Mailing Address - Phone:787-918-7254
Mailing Address - Fax:
Practice Address - Street 1:476 APPLETON ST STE 5
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3236
Practice Address - Country:US
Practice Address - Phone:978-799-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor