Healthcare Provider Details

I. General information

NPI: 1275901522
Provider Name (Legal Business Name): MARLENE MAJOR ED.D., CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARLENE M. MAJOR-AHMED ED.D., CP

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 TAFT AVE
MAYNARD MA
01754-1907
US

IV. Provider business mailing address

16 TAFT AVE
MAYNARD MA
01754-1907
US

V. Phone/Fax

Practice location:
  • Phone: 617-699-5906
  • Fax:
Mailing address:
  • Phone: 617-699-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10643
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: