Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1668 | MA |
N | 103T00000X | Psychologist | 1668 | MA |
N | 103G00000X | Clinical Psychologist | 1668 | MA |
N | 103TC0700X | Clinical Psychologist | 1668 | MA |
N | 103TH0100X | Health Service | 1668 | MA |
NPI | 1386797132 |
---|---|
Provider Name | Dr. Alvin Joseph Simmons |
First Address | East Freetown, MA 02717 |
Second Address | New Bedford, MA 02745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007435 | HARVARD PILGRIM HLTH (01) | MA |
W01894 | BCBS OF MA (01) | MA |