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NPI Code Detail

MEDICARE: MISS KERRIANN OSTLUND LICSW

MEDICARE: MISS KERRIANN OSTLUND 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 Worker122147MA

General Provider Information

NPI Number : 1841603396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KERRIANN OSTLUND LICSW
Provider Business Mailing Address
First Line : 10I ROESSLER RD
Second Line :
City : WOBURN
State : MA
Zip : 01801-6208
Country : US
Telephone Number : 781-932-8114
Fax Number :
Provider Business Practice Location Address
First Line : 41 MALL RD
Second Line :
City : BURLINGTON
State : MA
Zip : 01805-6208
Country : US
Telephone Number : 781-744-8085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2014
Last Update Date : 11/26/2019

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Directions to “ MISS KERRIANN OSTLUND LICSW” Practice Location

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