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General NPI Number Information
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NPI Number | 1639436702
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Entity Type | Organization
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Legal Business Name | BETH O'MALLEY, PSY.D.
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 20 TOWER ST.
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City | FRAMINGHAM
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State | MA
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Zip | 01701
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Country | US
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Telephone | 617-702-2384
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Fax |
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Provider Business Mailing Address
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Address Line | 20 TOWER ST.
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City | FRAMINGHAM
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State | MA
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Zip | 01701
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Country | US
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Telephone | 617-702-2384
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETH O'MALLEY
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Credential | PSY.D.
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Telephone | 617-702-2384
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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 | 9299
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License Number State | MA
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