Provider Demographics
NPI:1568790087
Name:SHEA FRAIZE, DINA M (BEHAVIORAL HEALTH)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:M
Last Name:SHEA FRAIZE
Suffix:
Gender:F
Credentials:BEHAVIORAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3400
Mailing Address - Country:US
Mailing Address - Phone:508-868-7489
Mailing Address - Fax:
Practice Address - Street 1:3 FARM HOUSE RD
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1450
Practice Address - Country:US
Practice Address - Phone:508-868-7489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23122881041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical