Healthcare Provider Details

I. General information

NPI: 1013996628
Provider Name (Legal Business Name): NANCY ANN HUXLEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1041
US

IV. Provider business mailing address

18 WINN RD
NASHUA NH
03062-1715
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-3645
  • Fax:
Mailing address:
  • Phone: 603-886-5096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7379
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: