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NPI 1104080274

NPI 1104080274 : DIANE CRAWFORD AHERN MS, CGC : BOSTON, MA

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General NPI Number Information
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    NPI Number           |    1104080274
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    Entity Type          |    Individual 
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    Provider Name        |    DIANE CRAWFORD AHERN MS, CGC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/17/2008
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    Last Update Date     |    07/17/2008
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Provider Practice Location Address
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    Address Line         |    75 FRANCIS ST 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02115-6110
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    Country              |    US
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    Telephone            |    617-732-4801
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    Fax                  |    617-264-6310
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Provider Business Mailing Address
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    Address Line         |    75 FRANCIS STREET 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02115
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    Country              |    US
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    Telephone            |    617-732-4801
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    Fax                  |    617-264-6310
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    170300000X
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    Taxonomy Name        |    Genetic Counselor (M.S.)
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    License Number       |    
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    License Number State |    
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