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General NPI Number Information
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NPI Number | 1154450468
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Entity Type | Individual
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Provider Name | PAMELA ALESSANDRA RASKIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 985 WASHINGTON ST
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City | BRAINTREE
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State | MA
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Zip | 02184-5434
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Country | US
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Telephone | 781-848-5674
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Fax |
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Provider Business Mailing Address
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Address Line | 37 WALKER ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-2412
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Country | US
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Telephone | 617-876-2482
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2625
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License Number State | MA
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