Individual
MRS. SUSANA KRIVATSY O'HARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
55 HERITAGE HILL CIRCLE, EASTHAM, MA 02642-0392
(508) 255-4355
(508) 255-4355
Mailing address
P.O. BOX 392, EASTHAM, MA 02642-0392
(508) 255-4355
(508) 255-4355
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110081217A
—
MA
01
—
W02460
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
10/17/2006
Last updated
08/25/2022
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