Provider Demographics
NPI:1497399448
Name:SEGAL, KIARA
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SANDY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-5808
Mailing Address - Country:US
Mailing Address - Phone:617-947-0539
Mailing Address - Fax:
Practice Address - Street 1:99 SANDY VALLEY RD
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5808
Practice Address - Country:US
Practice Address - Phone:617-947-0539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty