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General NPI Number Information
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NPI Number | 1730245150
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Entity Type | Individual
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Provider Name | UNKNOWN KRISHNABAI MSW LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 20 POND RD
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City | ASHBY
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State | MA
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Zip | 01431-1733
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Country | US
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Telephone | 978-827-1181
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Fax | 978-827-1179
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | ASHBY
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State | MA
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Zip | 01431-0160
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Country | US
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Telephone | 978-827-1181
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Fax | 978-827-1179
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110533
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License Number State | MA
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