=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023229671
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MALKA ALPERT YOUNG MSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 475 FRANKLIN ST SUITE 101
-----------------------------------------------------
City | FRAMINGHAM
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01702-6264
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-875-3100
-----------------------------------------------------
Fax | 508-875-4373
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 67 SHADOW OAK DR
-----------------------------------------------------
City | SUDBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01776-3165
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-443-0170
-----------------------------------------------------
Fax | 408-875-4373
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 104640
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------