Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1285909853 |
---|---|
Provider Name | Dr. Thomas A Eaton |
First Address | Norwood, MA 02062-5603 |
Second Address | Norwood, MA 02062-5603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2012 |
Last Update Date | 15/03/2012 |