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General NPI Number Information
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NPI Number | 1245687458
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Entity Type | Individual
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Provider Name | MARCIA CONANT PHD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 71 MAIN ST SUITE 2C
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City | WESTMINSTER
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State | MA
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Zip | 01473-1472
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Country | US
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Telephone | 978-668-5099
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Fax |
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Provider Business Mailing Address
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Address Line | 23 OLD SHIRLEY RD
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City | HARVARD
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State | MA
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Zip | 01451-1309
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Country | US
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Telephone | 978-456-9814
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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 | 4847
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License Number State | MA
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