Provider Demographics
NPI:1710975644
Name:DIES, KIRA A (SCM)
Entity Type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:A
Last Name:DIES
Suffix:
Gender:F
Credentials:SCM
Other - Prefix:MISS
Other - First Name:KIRA
Other - Middle Name:A
Other - Last Name:APSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGC
Mailing Address - Street 1:94 W SPRINGFIELD ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3303
Mailing Address - Country:US
Mailing Address - Phone:617-290-6657
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:CLS 14074
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-919-3009
Practice Address - Fax:617-919-2769
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS