Mara Salis, LICSW

Individual provider Active NPI Clinical Social Worker · Hanscom Afb, MA

NPI 1497837843 · NPPES record last updated Sep 5, 2018

Key facts

NPI
1497837843
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
111828 (MA)
Practice address
2 Eglin St
Hanscom Afb, MA 01731
Phone
(781) 274-6178
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
111828MAMDClinical Social Worker
004599CTMDAcute Care Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111828 MA Yes

Addresses

Primary practice location

2 Eglin St
Hanscom Afb, MA 01731

Mailing address

8 Carlson Cir
Natick, MA 01760-4205
Phone (781) 439-1123

Other providers in Hanscom Afb, MA

All providers in Hanscom Afb, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.