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General NPI Number Information
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NPI Number | 1629130646
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Entity Type | Individual
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Provider Name | JO ANN KUMINS LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11 RIVER ST
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City | WELLESLEY
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State | MA
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Zip | 02481-2098
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Country | US
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Telephone | 781-237-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHARLES ST S 3C
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City | BOSTON
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State | MA
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Zip | 02116-5431
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Country | US
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Telephone | 781-237-7979
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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 | 1020753
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License Number State | MA
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