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General NPI Number Information
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NPI Number | 1770384471
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Entity Type | Organization
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Legal Business Name | FRESH POND NEUROPSYCHOLOGY
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 09/14/2025
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Provider Practice Location Address
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Address Line | 725 CONCORD AVE
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City | CAMBRIDGE
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State | MA
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Zip | 02138-1040
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Country | US
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Telephone | 781-591-2884
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Fax |
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Provider Business Mailing Address
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Address Line | 725 CONCORD AVE
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City | CAMBRIDGE
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State | MA
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Zip | 02138-1040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | JOCELYN A WINZER
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Credential | PH.D.
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Telephone | 617-480-0180
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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 |
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License Number State |
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