Individual
MR. SHAUN DANIEL GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC 1
Contact information
Practice address
300 CONGRESS ST STE 104, QUINCY, MA 02169-0907
(617) 774-0331
(617) 774-0336
Mailing address
23 PIERCE ST, HYDE PARK, MA 02136-2981
(857) 615-9232
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12400
MA
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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