Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 213481 | MA |
NPI | 1003013228 |
---|---|
Provider Name | Kristen M Casey |
First Address | Brighton, MA 02135-7837 |
Second Address | Brighton, MA 02135-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |