Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 113749 | MA |
NPI | 1003022799 |
---|---|
Provider Name | Ms. Bridget Kiely Chiaruttini |
First Address | Boston, MA 02118-3463 |
Second Address | Boston, MA 02118-3463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |