Individual
ANNE G. GEOGHEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
55 CHESTNUT ST, BOSTON, MA 02108-3506
(617) 873-9130
Mailing address
55 CHESTNUT ST, BOSTON, MA 02108-3506
(617) 873-9130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
103945
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GE PO4705
BLUE CROSS PROVIDER #
MA
Enumeration date
01/19/2007
Last updated
07/08/2007
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