Healthcare Provider Details

I. General information

NPI: 1740378678
Provider Name (Legal Business Name): JANE N APPELL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAMONMILL SQUARE SUITE 3-1A 9 POND LANE
CONCORD MA
01742-2858
US

IV. Provider business mailing address

56 WINTER ST
LINCOLN MA
01773-3504
US

V. Phone/Fax

Practice location:
  • Phone: 978-287-4300
  • Fax: 978-369-0400
Mailing address:
  • Phone: 781-259-1049
  • Fax: 781-259-1049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number3851
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: