MEDICARE: CECILIA FERNANDEZ-HALL PH.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	7961	MA

General Provider Information

NPI Number	:	1528028453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA FERNANDEZ-HALL PH.D.

Provider Business Mailing Address
First Line	:	805 TURNPIKE ST STE 101
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-6122
Country	:	US
Telephone Number	:	978-252-3441
Fax Number	:	978-252-3450

Provider Business Practice Location Address
First Line	:	805 TURNPIKE ST STE 102
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-6122
Country	:	US
Telephone Number	:	978-252-3441
Fax Number	:	978-252-3450

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	05/07/2024

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