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General NPI Number Information
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NPI Number | 1881841625
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Entity Type | Individual
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Provider Name | BRIAN D. MASSEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 23 E ELM AVE
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City | QUINCY
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State | MA
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Zip | 02170-2905
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Country | US
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Telephone | 617-745-3574
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Fax | 617-745-3939
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Provider Business Mailing Address
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Address Line | 35 SPROUL RD
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City | HANOVER
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State | MA
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Zip | 02339-2843
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Country | US
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Telephone | 617-745-3574
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Fax | 617-745-3939
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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 | 8902
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License Number State | MA
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