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General NPI Number Information
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NPI Number | 1043427750
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Entity Type | Individual
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Provider Name | KIMBERLY FARIS PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 26 CENTRAL ST
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City | SOMERVILLE
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State | MA
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Zip | 02143-2827
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Country | US
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Telephone | 617-575-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 295 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776-3046
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Country | US
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Telephone | 978-443-6681
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Fax |
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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 |
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License Number State |
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