Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 6811 | MA |
N | 103T00000X | Psychologist | 6811 | MA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6811 | MA |
Y | 103G00000X | Clinical Psychologist | 6811 | MA |
Y | 103TC0700X | Clinical Psychologist | 6811 | MA |
N | 103TF0000X | Family Psychologist | 6811 | MA |
N | 103TH0100X | Health Service | 6811 | MA |
N | 103TP2701X | Group Psychotherapist | 6811 | MA |
NPI | 1164527081 |
---|---|
Provider Name | Angel R. Seibring |
First Address | Arlington, MA 02474-8406 |
Second Address | Arlington, MA 02474-8406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 22/06/2010 |