Provider Demographics
NPI:1992157820
Name:DESINORD, TAHINA
Entity type:Individual
Prefix:
First Name:TAHINA
Middle Name:
Last Name:DESINORD
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 1:366 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3831
Mailing Address - Country:US
Mailing Address - Phone:617-412-6269
Mailing Address - Fax:
Practice Address - Street 1:55 BOSTON PROVIDENCE TPKE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2624
Practice Address - Country:US
Practice Address - Phone:857-472-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-03
Last Update Date:2016-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker