Basic Information
| Provider Information | |||||||||
| NPI: | 1164576641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOBART | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | KATHLEEN | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 96 BELMONT STREET | ||||||||
| Address2: | 2 | ||||||||
| City: | SOMERVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174136583 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33 EAST MERRIMACK STREET | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784536800 | ||||||||
| FaxNumber: | 9784536767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.