Provider Demographics
NPI:1649559527
Name:O'HAGAN, PATRICIA (LADC1)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:O'HAGAN
Suffix:
Gender:F
Credentials:LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-2215
Mailing Address - Country:US
Mailing Address - Phone:781-337-1253
Mailing Address - Fax:
Practice Address - Street 1:52 WHITE ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1350
Practice Address - Country:US
Practice Address - Phone:617-569-2089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA529101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)