Provider Demographics
NPI:1063714384
Name:CLAUDOMIR, DAPHNE ROLLANDE (M ED)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:ROLLANDE
Last Name:CLAUDOMIR
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4414
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33424-4414
Mailing Address - Country:US
Mailing Address - Phone:781-885-7530
Mailing Address - Fax:
Practice Address - Street 1:966 PARK ST STE A2
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3664
Practice Address - Country:US
Practice Address - Phone:781-885-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)