Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 7225 | MA |
NPI | 1104186386 |
---|---|
Provider Name | Jane Munzer Greenstein |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 22/05/2012 |