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General NPI Number Information
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NPI Number | 1336508217
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Entity Type | Organization
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Legal Business Name | RACHEL LIVELY INCORPORATED
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Dates
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Enumeration Date | 02/19/2016
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 25 MARKET ST SUITE 14
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City | SWANSEA
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State | MA
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Zip | 02777-3999
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Country | US
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Telephone | 508-221-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MARKET ST SUITE 14
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City | SWANSEA
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State | MA
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Zip | 02777-3999
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Country | US
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Telephone | 508-221-4844
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | RACHEL LIVELY
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Credential |
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Telephone | 508-221-4844
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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 | 8729
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License Number State | MA
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