Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PS01455 | RI |
N | 103TC0700X | Clinical Psychologist | PS01455 | RI |
Y | 102L00000X | Psychologist | 10592 | MA |
Y | 103T00000X | Psychologist | 10592 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PS01455 | RI |
NPI | 1124437264 |
---|---|
Provider Name | Meredith Amaya-Hodges |
First Address | Andover, MA 01810-3600 |
Second Address | Andover, MA 01810-3600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2014 |
Last Update Date | 02/04/2021 |