Individual
COLLEEN KELLY DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 STANIFORD ST, BOSTON, MA 02114-2503
(857) 284-4275
Mailing address
15 MIDDLE ST, BOSTON, MA 02127-2718
(857) 207-9982
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
000223891
MA
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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