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General NPI Number Information
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NPI Number | 1023041894
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Entity Type | Individual
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Provider Name | DIANA M RONELL PHD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 366 MASSACHUSETTS AVE SUITE 101
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City | ARLINGTON
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State | MA
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Zip | 02474-6733
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Country | US
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Telephone | 617-491-1296
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 397008 MIT BRANCH
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City | CAMBRIDGE
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State | MA
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Zip | 02139-7008
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Country | US
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Telephone | 617-491-1296
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Fax | 617-726-2894
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6913
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License Number State | MA
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