Healthcare Provider Details

I. General information

NPI: 1255885125
Provider Name (Legal Business Name): FABIENNE BAIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 PLEASANT ST STE 203
ARLINGTON MA
02476-6534
US

IV. Provider business mailing address

94 PLEASANT ST STE 203
ARLINGTON MA
02476-6534
US

V. Phone/Fax

Practice location:
  • Phone: 857-203-0010
  • Fax:
Mailing address:
  • Phone: 857-203-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number11424
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number021743
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: