Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9585 | MA |
Y | 103TC0700X | Clinical Psychologist | 9585 | MA |
NPI | 1003125352 |
---|---|
Provider Name | Aliza C Yarrow |
First Address | Cambridge, MA 02138-2322 |
Second Address | Cambridge, MA 02138-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2010 |
Last Update Date | 30/10/2012 |