Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | 10986 | MA |
Y | 103T00000X | Psychologist | 10986 | MA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 000 |
NPI | 1033564885 |
---|---|
Provider Name | Rachel Goldin |
First Address | Lexington, MA 02421-3114 |
Second Address | Lexington, MA 02421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2016 |
Last Update Date | 17/01/2019 |