Provider Demographics
NPI:1205071412
Name:LIQUORI, KATHLEEN G (MA)
Entity type:Individual
Prefix:MR
First Name:KATHLEEN
Middle Name:G
Last Name:LIQUORI
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 1:74 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7959
Mailing Address - Country:US
Mailing Address - Phone:508-875-2055
Mailing Address - Fax:
Practice Address - Street 1:74 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7959
Practice Address - Country:US
Practice Address - Phone:508-875-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health