Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 2459- PY PR | MA |
N | 103TC1900X | Counseling Psychologist | 2459- PY PR | MA |
Y | 103TC1900X | Counseling Psychologist | 2459-PY PR | MA |
NPI | 1033650908 |
---|---|
Provider Name | Jean Curtis Loud |
First Address | Oak Bluffs, MA 02557-1113 |
Second Address | Oak Bluffs, MA 02557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2017 |
Last Update Date | 13/03/2017 |