MEDICARE: KATHLEEN MARY HIRO MS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	104100000X	Social Worker
3	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346380805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MARY HIRO MS

Provider Business Mailing Address
First Line	:	599 SW INDIAN KEY DR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-2053
Country	:	US
Telephone Number	:	772-380-9972
Fax Number	:	772-380-9976

Provider Business Practice Location Address
First Line	:	2100 SE HILLMOOR DR STE 104
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-8057
Country	:	US
Telephone Number	:	772-380-9972
Fax Number	:	772-380-9976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	01/31/2023

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