MEDICARE: KATHERINE MARIE DOOLEY LIC. AC.

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
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1366887911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MARIE DOOLEY LIC. AC.

Provider Business Mailing Address
First Line	:	87 WYMAN ST
Second Line	:
City	:	WABAN
State	:	MA
Zip	:	02468-1516
Country	:	US
Telephone Number	:	617-965-4055
Fax Number	:	617-965-4255

Provider Business Practice Location Address
First Line	:	87 WYMAN ST
Second Line	:
City	:	WABAN
State	:	MA
Zip	:	02468-1516
Country	:	US
Telephone Number	:	617-965-4055
Fax Number	:	617-965-4255

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

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	05/07/2018

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