Provider Demographics
NPI:1336450667
Name:CREGAN, MARTHA E (BA)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:CREGAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CABOT RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5177
Mailing Address - Country:US
Mailing Address - Phone:781-395-0625
Mailing Address - Fax:781-395-0198
Practice Address - Street 1:10 CABOT RD
Practice Address - Street 2:SUITE 209
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5177
Practice Address - Country:US
Practice Address - Phone:781-395-0625
Practice Address - Fax:781-395-0198
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor