Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2958 | MA |
Y | 103T00000X | Psychologist | 2958 | MA |
NPI | 1003053810 |
---|---|
Provider Name | Dr. William Arthur Winn III |
First Address | Boston, MA 02110-3605 |
Second Address | Boston, MA 02110-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2009 |
Last Update Date | 15/01/2009 |