Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | 3330 | MA |
NPI | 1750879383 |
---|---|
Provider Name | Dr. Rosemary Klein |
First Address | Waltham, MA 02452-6118 |
Second Address | Waltham, MA 02452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2018 |
Last Update Date | 30/04/2018 |