MEDICARE: DR. WILLIAM DALE COX ED.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1961	MA
2	103TP0814X	Psychoanalysis Psychologist

General Provider Information

NPI Number	:	1316943582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM DALE COX ED.D.

Provider Business Mailing Address
First Line	:	5 EAST MAIN STREET
Second Line	:	SUITE 1A
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581
Country	:	US
Telephone Number	:	508-898-9133
Fax Number	:	508-898-9633

Provider Business Practice Location Address
First Line	:	5 EAST MAIN STREET
Second Line	:	SUITE 1A
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581
Country	:	US
Telephone Number	:	508-898-9133
Fax Number	:	508-898-9633

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/24/2014

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