Provider Demographics
NPI:1285923318
Name:BUOTE, DORA E
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:E
Last Name:BUOTE
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 1:68 MASCUPPIC TRL
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-1736
Mailing Address - Country:US
Mailing Address - Phone:978-995-4286
Mailing Address - Fax:
Practice Address - Street 1:9 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1927
Practice Address - Country:US
Practice Address - Phone:978-459-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health