MEDICARE: MS. ALISON HILARY WORCESTER LM

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	176B00000X	Midwife	LM 170	CA

General Provider Information

NPI Number	:	1619906898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALISON HILARY WORCESTER LM

Provider Business Mailing Address
First Line	:	3566 17TH ST
Second Line	:	#4
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-6500
Country	:	US
Telephone Number	:	415-255-7028
Fax Number	:

Provider Business Practice Location Address
First Line	:	3566 17TH ST
Second Line	:	#4
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-6500
Country	:	US
Telephone Number	:	415-255-7028
Fax Number	:

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/08/2007

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