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General NPI Number Information
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NPI Number | 1164550901
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Entity Type | Individual
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Provider Name | CRISTIN HEAGNEY POIRIER LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 WASHINGTON ST MILL RIVER PROFESSIONAL CENTER
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City | TAUNTON
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State | MA
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Zip | 02780-3960
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Country | US
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Telephone | 508-977-8018
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Fax |
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Provider Business Mailing Address
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Address Line | 29 DAVENPORT ST
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City | TAUNTON
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State | MA
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Zip | 02780-4705
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Country | US
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Telephone | 508-997-8018
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111475
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License Number State | MA
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