Healthcare Provider Details

I. General information

NPI: 1891847232
Provider Name (Legal Business Name): WILLIAM L. ENGELS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 DERBY ST SUITE 10
HINGHAM MA
02043-4007
US

IV. Provider business mailing address

175 DERBY ST SUITE 10
HINGHAM MA
02043-4007
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-1300
  • Fax:
Mailing address:
  • Phone: 781-749-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4929
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: