Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 8211 | MA |
N | 103T00000X | Psychologist | 8211 | MA |
N | 103G00000X | Clinical Psychologist | 8211 | MA |
N | 103TC0700X | Clinical Psychologist | 8211 | MA |
N | 103TP2701X | Group Psychotherapist | 8211 | MA |
NPI | 1003837097 |
---|---|
Provider Name | Dr. Michaela Mendelsohn |
First Address | Cambridge, MA 02138-1836 |
Second Address | Cambridge, MA 02138-1836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 08/07/2007 |