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General NPI Number Information
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NPI Number | 1306217237
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Entity Type | Organization
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Legal Business Name | BOSTON CHILD & ADOLESCENT ASSESSMENT LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 124 WATERTOWN ST SUITE 3A EAST
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City | WATERTOWN
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State | MA
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Zip | 02472-2576
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Country | US
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Telephone | 617-600-6342
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Fax | 888-975-4481
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Provider Business Mailing Address
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Address Line | PO BOX 83
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City | SWAMPSCOTT
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State | MA
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Zip | 01907-0083
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Country | US
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Telephone | 617-600-6342
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Fax | 888-975-4481
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | CHRISTINE SADOWSKI
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Credential | PHD
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Telephone | 617-600-6342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 9236
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License Number State | MA
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