Healthcare Provider Details

I. General information

NPI: 1407941727
Provider Name (Legal Business Name): KIMBERLY DIGREGORIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 INDUSTRIAL PARK ROAD
HINGHAM MA
02043
US

IV. Provider business mailing address

564 WASHINGTON STREET APT #3
WHITMAN MA
02382
US

V. Phone/Fax

Practice location:
  • Phone: 781-608-6161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS29523735
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: