MEDICARE: MRS. MELANIE COLLINS O'LEARY MS

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	170300000X	Genetic Counselor (M.S.)	GC088	MA

General Provider Information

NPI Number	:	1508881798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE COLLINS O'LEARY MS

Provider Business Mailing Address
First Line	:	3400 COMPUTER DR
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1771
Country	:	US
Telephone Number	:	508-389-8328
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 COMPUTER DR
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-1771
Country	:	US
Telephone Number	:	508-389-8328
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	04/01/2012

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