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General NPI Number Information
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NPI Number | 1821693524
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Entity Type | Individual
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Provider Name | KAYCEE O'TOOLE
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 460 QUINCY AVE
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City | QUINCY
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State | MA
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Zip | 02169-8130
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Country | US
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Telephone | 617-774-6078
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Fax |
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Provider Business Mailing Address
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Address Line | 37 VASSALL ST
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City | QUINCY
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State | MA
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Zip | 02170-2116
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Country | US
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Telephone | 617-981-3061
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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 | 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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