Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1164961371 |
---|---|
Provider Name | Rebecca Caldwell |
First Address | Athol, MA 01331-1846 |
Second Address | Athol, MA 01331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2017 |
Last Update Date | 18/06/2019 |