Provider Demographics
NPI:1124427315
Name:CANUTO, MELISA ROSA
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:ROSA
Last Name:CANUTO
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 1:8 WASHINGTON ST
Mailing Address - Street 2:303
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-1444
Mailing Address - Country:US
Mailing Address - Phone:617-433-8720
Mailing Address - Fax:
Practice Address - Street 1:8 WASHINGTON ST
Practice Address - Street 2:303
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-1444
Practice Address - Country:US
Practice Address - Phone:617-433-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1170721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical