Provider Demographics
NPI:1174876593
Name:O'HALLORAN, CATHERINE EMILY (ND)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:EMILY
Last Name:O'HALLORAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SIBLEY ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01519-1305
Mailing Address - Country:US
Mailing Address - Phone:508-839-9481
Mailing Address - Fax:
Practice Address - Street 1:551 BOYLSTON ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3605
Practice Address - Country:US
Practice Address - Phone:617-447-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0090608175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath