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General NPI Number Information
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NPI Number | 1649356841
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Entity Type | Organization
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Legal Business Name | FRANCISCAN HOSPITAL FOR CHILDREN
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 30 WARREN ST
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City | BRIGHTON
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State | MA
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Zip | 02135-3602
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Country | US
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Telephone | 617-254-3800
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Fax | 617-779-1262
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Provider Business Mailing Address
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Address Line | 30 WARREN ST
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City | BRIGHTON
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State | MA
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Zip | 02135-3602
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Country | US
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Telephone | 617-254-3800
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Fax | 617-779-1262
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Authorized Official
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Title or Position | DIRECTOR, STAFF PSYCHOLOGIST
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Name | DR. MARY ANN MULLIN
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Credential | PH.D.
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Telephone | 617-254-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6556
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License Number State | MA
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