Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TS0200X | School Psychologist | 523388 |
NPI | 1013508399 |
---|---|
Provider Name | Aberdine Rhiannon Donaldson |
First Address | Boston, MA 02119-2653 |
Second Address | Brighton, MA 02135-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2021 |
Last Update Date | 22/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
523388 | MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION (01) | MA |