Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1073947214 |
---|---|
Provider Name | Dr. Shannon Estelle Hourigan |
First Address | Boston, MA 02118-3164 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2013 |
Last Update Date | 23/08/2013 |