Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 11360 | MA |
Y | 103TE1100X | Exercise & Sports Psychologist | 11360 | MA |
NPI | 1043817489 |
---|---|
Provider Name | Dr. Trevor Allan Cote |
First Address | Waltham, MA 02452-5618 |
Second Address | Boston, MA 02116-2912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2020 |
Last Update Date | 08/10/2020 |