Provider Demographics
NPI:1467789818
Name:SHIH, KIRSTEN SHUO-HUEI (MA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:SHUO-HUEI
Last Name:SHIH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1507
Mailing Address - Country:US
Mailing Address - Phone:857-277-3913
Mailing Address - Fax:
Practice Address - Street 1:70 FORSYTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5026
Practice Address - Country:US
Practice Address - Phone:617-774-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225A00000X
10122225A00000X
MA9429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist