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NPI 1952437303

NPI 1952437303 : MAUREEN MARGARET CONNEELY LICSW : QUINCY, MA

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General NPI Number Information
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    NPI Number           |    1952437303
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    Entity Type          |    Individual 
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    Provider Name        |    MAUREEN MARGARET CONNEELY LICSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/27/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    22 SPEAR ST 
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02169-4514
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    Country              |    US
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    Telephone            |    617-816-7213
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    29 WHITE ST 
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02169-1426
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    Country              |    US
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    Telephone            |    617-816-7213
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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       |    111514
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    License Number State |    MA
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