Healthcare Provider Details

I. General information

NPI: 1477539427
Provider Name (Legal Business Name): MARSHA ANITA FRANKEL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HARVARD AVE #1
BROOKLINE MA
02446-6243
US

IV. Provider business mailing address

77 HARVARD AVE #1
BROOKLINE MA
02446-6243
US

V. Phone/Fax

Practice location:
  • Phone: 617-730-5959
  • Fax:
Mailing address:
  • Phone: 617-730-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100427
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: