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NPI Code Detail

MEDICARE: MOLLY SHEEHAN

MEDICARE: MOLLY SHEEHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist
2103K00000XBehavior AnalystLABA10000426MA

General Provider Information

NPI Number : 1043687437
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY SHEEHAN
Provider Business Mailing Address
First Line : 100 CUMMINGS CTR STE 135C
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6263
Country : US
Telephone Number : 978-473-7300
Fax Number :
Provider Business Practice Location Address
First Line : 100 CUMMINGS CTR STE 135C
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6263
Country : US
Telephone Number : 978-473-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 04/30/2024

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Directions to “ MOLLY SHEEHAN ” Practice Location

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