Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1427253087 |
---|---|
Provider Name | Ms. Elizabeth Ann Mcauliffe |
First Address | West Roxbury, MA 02132-5536 |
Second Address | Boston, MA 02114-2002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |