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General NPI Number Information
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NPI Number | 1497079222
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Entity Type | Organization
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Legal Business Name | ALAN ROY PSYD LLC
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 26 WEST ST
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City | BEVERLY
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State | MA
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Zip | 01915-2226
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Country | US
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Telephone | 978-338-5637
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3341
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City | BEVERLY
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State | MA
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Zip | 01915-0894
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Country | US
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Telephone | 978-338-5637
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Fax | 978-910-0268
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ALAN ROY
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Credential | PSY.D.
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Telephone | 978-338-5637
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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 | 9033
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License Number State | MA
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