Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 3814 | MA |
NPI | 1104158039 |
---|---|
Provider Name | Dr. Harry W. Parad |
First Address | Jamaica Plain, MA 02130-1862 |
Second Address | Jamaica Plain, MA 02130-1862 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2010 |
Last Update Date | 26/05/2016 |