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General NPI Number Information
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NPI Number | 1609305796
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Entity Type | Individual
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Provider Name | SIOBHAN FLANAGAN LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 859 WILLARD ST STE 420
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City | QUINCY
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State | MA
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Zip | 02169-7469
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Country | US
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Telephone | 617-903-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 131 GILSON RD
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City | SCITUATE
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State | MA
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Zip | 02066-4644
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Country | US
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Telephone | 215-384-3390
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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 | 120252
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License Number State | MA
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