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NPI Code Detail

MEDICARE: MS. JULIE ANN O'HARA LICSW

MEDICARE: MS. JULIE ANN O'HARA LICSW
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
11041C0700XClinical Social Worker1022484MA

General Provider Information

NPI Number : 1427068121
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE ANN O'HARA LICSW
Provider Business Mailing Address
First Line : 100 POWDERMILL RD # 143
Second Line :
City : ACTON
State : MA
Zip : 01720-5932
Country : US
Telephone Number : 978-219-2398
Fax Number :
Provider Business Practice Location Address
First Line : 100 POWDERMILL RD # 143
Second Line :
City : ACTON
State : MA
Zip : 01720-5932
Country : US
Telephone Number : 978-219-2398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 09/14/2022

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