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NPI Code Detail

MEDICARE: MS. FRANCES GANNON LMFT

MEDICARE: MS. FRANCES GANNON LMFT
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
1106H00000XMarriage & Family Therapist1122MA

General Provider Information

NPI Number : 1215354303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FRANCES GANNON LMFT
Provider Business Mailing Address
First Line : 3313 WASHINGTON ST
Second Line : 2ND FLOOR
City : JAMAICA PLAIN
State : MA
Zip : 02130-2691
Country : US
Telephone Number : 617-522-0650
Fax Number : 617-522-0652
Provider Business Practice Location Address
First Line : 3313 WASHINGTON ST
Second Line : 2ND FLOOR
City : JAMAICA PLAIN
State : MA
Zip : 02130-2691
Country : US
Telephone Number : 617-522-0650
Fax Number : 617-522-0652
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2014
Last Update Date : 03/26/2014

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Directions to “ MS. FRANCES GANNON LMFT” Practice Location

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