Provider Demographics
NPI:1386495570
Name:KABOCHI, DAISY WAIRIMU
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:WAIRIMU
Last Name:KABOCHI
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 1:264 N MAIN ST STE 10
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1837
Mailing Address - Country:US
Mailing Address - Phone:860-461-7792
Mailing Address - Fax:860-650-0567
Practice Address - Street 1:264 N MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-1837
Practice Address - Country:US
Practice Address - Phone:860-461-7792
Practice Address - Fax:860-650-0567
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor