Healthcare Provider Details

I. General information

NPI: 1164951497
Provider Name (Legal Business Name): ATTENTION BEHAVIOR AND COGNITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 06/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MAIN ST STE 10
HOLDEN MA
01520-1838
US

IV. Provider business mailing address

2 BIRCH HILL RD
HOLDEN MA
01520-1948
US

V. Phone/Fax

Practice location:
  • Phone: 508-627-2474
  • Fax:
Mailing address:
  • Phone: 508-627-2474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN MICHAEL GAY
Title or Position: OWNER
Credential: PSY.D.
Phone: 508-627-2474