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General NPI Number Information
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NPI Number | 1457494049
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Entity Type | Individual
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Provider Name | RONA L. TANANBAUM PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 FRANKLIN COMMONS
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City | FRAMINGHAM
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State | MA
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Zip | 01702-6619
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Country | US
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Telephone | 508-872-6610
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Fax | 508-872-6722
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Provider Business Mailing Address
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Address Line | 17 LOWE CIR
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City | FRAMINGHAM
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State | MA
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Zip | 01701-7632
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Country | US
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Telephone | 508-877-6825
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Fax | 508-872-6722
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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 | 3783
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License Number State | MA
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