Provider Demographics
NPI:1396164505
Name:GODAIRE, ALEJANDRA (MSW)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:GODAIRE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:IRIS FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:391 VARNUM AVENUE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-322-5095
Mailing Address - Fax:
Practice Address - Street 1:391 VARNUM AVENUE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-322-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health