Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 3937 | MA |
N | 103TC0700X | Clinical Psychologist | 3937 | MA |
N | 102L00000X | Psychologist | 3937 | MA |
N | 103T00000X | Psychologist | 3937 | MA |
N | 103TA0700X | Adult Development & Aging Psychologist | 3937 | MA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 3937 | MA |
N | 103G00000X | Clinical Psychologist | 3937 | MA |
N | 103TC0700X | Clinical Psychologist | 3937 | MA |
N | 103TC1900X | Counseling Psychologist | 3937 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3937 | MA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 3937 | MA |
N | 103TR0400X | Rehabilitation Psychologist | 3937 | MA |
N | 103TS0200X | School Psychologist | 3937 | MA |
NPI | 1346387834 |
---|---|
Provider Name | Dr. Janice Plunkett D'avignon |
First Address | Quincy, MA 02169-7804 |
Second Address | Quincy, MA 02169-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |