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General NPI Number Information
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NPI Number | 1881823037
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Entity Type | Individual
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Provider Name | THOMAS WAHLUND PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 77 VALLEY RD
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City | SOUTHAMPTON
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State | MA
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Zip | 01073-9532
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Country | US
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Telephone | 413-341-0342
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Fax | 866-277-1901
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Provider Business Mailing Address
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Address Line | 77 VALLEY RD
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City | SOUTHAMPTON
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State | MA
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Zip | 01073-9532
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Country | US
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Telephone | 724-840-1226
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Fax | 866-277-1901
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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 | 10355
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License Number State | MA
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