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General NPI Number Information
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NPI Number | 1548772528
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Entity Type | Individual
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Provider Name | IMAN HANAFI
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Gender | Female
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1245 HANCOCK ST STE 25
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City | QUINCY
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State | MA
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Zip | 02169-4365
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Country | US
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Telephone | 617-396-6434
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Fax |
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Provider Business Mailing Address
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Address Line | 650 HUNTINGTON AVE APT 6J
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City | BOSTON
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State | MA
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Zip | 02115-5914
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Country | US
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Telephone | 617-396-6434
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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