Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YS0200X | School Counselor | 335996 | MA |
Y | 1041C0700X | Clinical Social Worker | 1023429 | MA |
NPI | 1144599317 |
---|---|
Provider Name | Alfred Cramer Decker |
First Address | Norwell, MA 02061-0375 |
Second Address | Norwell, MA 02061-1755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2011 |
Last Update Date | 04/01/2012 |