Healthcare Provider Details

I. General information

NPI: 1861532988
Provider Name (Legal Business Name): MEREDITH M HOBSON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MOUNT AUBURN ST SOCIAL WORK DEPARTMENT
CAMBRIDGE MA
02138-5502
US

IV. Provider business mailing address

330 MOUNT AUBURN ST SOCIAL WORK DEPARTMENT
CAMBRIDGE MA
02138-5502
US

V. Phone/Fax

Practice location:
  • Phone: 617-499-5665
  • Fax:
Mailing address:
  • Phone: 617-499-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113130
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: