Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY 3501 PR | MA |
N | 103TC0700X | Clinical Psychologist | PY 3501 PR | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY 3501 PR | MA |
N | 103TH0100X | Health Service | PY 3501 PR | MA |
NPI | 1609843531 |
---|---|
Provider Name | Dr. Karen G Schwartz |
First Address | Belmont, MA 02478-3924 |
Second Address | Belmont, MA 02478-3924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
W03571 | BLUE CROSS BLUE SHIELD (01) | MA |