Individual
KATHLEEN C WHOOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
110 W SQUANTUM ST, SUITE 21, NORTH QUINCY, MA 02171-2122
(617) 786-7467
Mailing address
110 W SQUANTUM ST, SUITE 21, NORTH QUINCY, MA 02171-2122
(617) 786-7467
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1020934
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1854241
—
MA
01
—
P08435
BCBS ID
MA
Enumeration date
02/27/2007
Last updated
07/09/2007
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