Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003277682 |
---|---|
Provider Name | Ms. Christine G Hagberg |
First Address | Dedham, MA 02026-4455 |
Second Address | Milford, MA 01757-1748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2016 |
Last Update Date | 10/03/2016 |