Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | MH 446-ED | MA |
NPI | 1063621472 |
---|---|
Provider Name | Mr. Michael Francis Mcquaid |
First Address | West Wareham, MA 02576-1469 |
Second Address | Wareham, MA 02571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |