Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 2003 | MA |
N | 103T00000X | Psychologist | 2003 | MA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2003 | MA |
N | 103TA0700X | Adult Development & Aging Psychologist | 2003 | MA |
Y | 103G00000X | Clinical Psychologist | 2003 | MA |
Y | 103TC0700X | Clinical Psychologist | 2003 | MA |
N | 103TC1900X | Counseling Psychologist | 2003 | MA |
N | 103TF0000X | Family Psychologist | 2003 | MA |
N | 103TH0100X | Health Service | 2003 | MA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 2003 | MA |
N | 103TR0400X | Rehabilitation Psychologist | 2003 | MA |
NPI | 1093868077 |
---|---|
Provider Name | Dr. Donald L. Angell |
First Address | Quincy, MA 02169-1200 |
Second Address | Quincy, MA 02169-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 02/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026023 | AETNA (01) | MA |
WO2184 | BLUE CROSS (01) | MA |