Doctor Name: | MS. KRISTIN M DAME |
NPI Number: | 1053626911 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LMHC |
License Number: | 5116 |
Business Practice Address: | 46 River St Mattapan, MA - 021262952 |
Business Phone Number: | 6176992549 |
Business Fax Number: | |
Mailing Address: | 190 Lenox St, NORWOOD |
State: | MA |
Postal Code: | 020623416 |
Phone Number: | 7817698674 |
Fax Number: | |
NPI Enumeration Date: | 08/16/2010 |
NPI Last Update Date: | 08/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |