Advanced Neurotherapy, PC
Psychologist, Cognitive & Behavioral in Wellesley, MA. Organization (NPI-2).
NPI number1104846476
StatusActive
Last updated in NPPESJun 15, 2023
Details
- NPI
- 1104846476
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Neurotherapy, PC
- Organization subpart
- No
- Enumeration date
- Jul 20, 2006
- Certification date
- Jun 15, 2023
- Last updated
- Jun 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TB0200X | Psychologist, Cognitive & Behavioral | 3976 | MA | Yes |
Practice location
140 Bristol RdWellesley, MA 02481-2730
Phone 781-444-9115
Mailing address
10436 Park Tree PlGlen Allen, VA 23060-4487
Phone 781-444-9115
Authorized official
Jolene Ross
Licensed Psychologist/Director
7814449115
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