MEDICARE: CATHERINE GRACE MULDOON HALL

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	104100000X	Social Worker	228677	MA

General Provider Information

NPI Number	:	1578309324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE GRACE MULDOON HALL

Provider Business Mailing Address
First Line	:	370 MAIN ST STE 910
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01608-1723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 MAIN ST STE 910
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01608-1723
Country	:	US
Telephone Number	:	978-886-8725
Fax Number	:

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

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	07/02/2024

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Directions to “ CATHERINE GRACE MULDOON HALL ” Practice Location

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