Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 11333 | MA |
Y | 103TC0700X | Clinical Psychologist | 11333 | MA |
NPI | 1003446782 |
---|---|
Provider Name | Kara Naylon |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01606-1244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2020 |
Last Update Date | 22/12/2020 |