Healthcare Provider Details

I. General information

NPI: 1265455844
Provider Name (Legal Business Name): GAIL ROBYN ARNOLD M.PSYCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 HIGHLAND AVE OPMH, NORTHSHORE CHILDRENS HOSPITAL
SALEM MA
01970
US

IV. Provider business mailing address

62 HILL ST
LEXINGTON MA
02421-4318
US

V. Phone/Fax

Practice location:
  • Phone: 978-741-1215
  • Fax:
Mailing address:
  • Phone: 781-860-9182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5137
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: