Healthcare Provider Details

I. General information

NPI: 1336228899
Provider Name (Legal Business Name): KARL J TOEWS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 AVALON DR
BEDFORD MA
01730-2067
US

IV. Provider business mailing address

304 AVALON DR
BEDFORD MA
01730-2067
US

V. Phone/Fax

Practice location:
  • Phone: 857-201-0170
  • Fax:
Mailing address:
  • Phone: 857-201-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8588
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: