Individual
CIARA MCGOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
4933-SP-AU
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14440127
CCC-A; ASHA CERTIFICATION
MA
01
—
15747685
CAQH
MA
01
—
4933-SP-AU
MA AUDIOLOGY LICENSE
MA
Enumeration date
10/26/2022
Last updated
11/17/2022
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