Individual
CATHRYN FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 BRIGHTON AVE, ALLSTON, MA 02134-2346
(603) 305-4502
Mailing address
56 BRIGHTON AVE, ALLSTON, MA 02134-2346
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421
MASSHEALTH
—
Enumeration date
01/22/2020
Last updated
01/22/2020
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