Healthcare Provider Details

I. General information

NPI: 1467119792
Provider Name (Legal Business Name): SEXUAL HEALTH AND HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 SHAWSHEEN RD
BEDFORD MA
01730-1924
US

IV. Provider business mailing address

186 ALEWIFE BROOK PKWY # 1043
CAMBRIDGE MA
02138-1121
US

V. Phone/Fax

Practice location:
  • Phone: 603-566-5414
  • Fax:
Mailing address:
  • Phone: 603-566-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MICHELE WALDRON
Title or Position: OWNER
Credential: PSY.D
Phone: 603-566-5414