| Blue Heron Therapy, Llc | |
|
165 Main St Unit 203 Medway MA 02053-1584 | |
| (774) 613-0436 | |
| Not Available |
| Full Name | Blue Heron Therapy, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 165 Main St Unit 203, Medway, Massachusetts |
| Authorized Official Name and Position | Katelyn Emma (SOLE MEMBER) |
| Authorized Official Contact | 7745736185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Heron Therapy, Llc 165 Main St Unit 203 Medway MA 02053-1584 Ph: () - | Blue Heron Therapy, Llc 165 Main St Unit 203 Medway MA 02053-1584 Ph: (774) 613-0436 |
| NPI Number | 1598435265 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598435265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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