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General NPI Number Information
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NPI Number | 1932204377
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Entity Type | Individual
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Provider Name | SETH ALEXANDRE DOOLIN PSYD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 101 CAMBRIDGE ST STE 300
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City | BURLINGTON
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State | MA
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Zip | 01803-3768
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Country | US
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Telephone | 857-205-3156
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CAMBRIDGE ST STE 300
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City | BURLINGTON
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State | MA
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Zip | 01803-3768
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Country | US
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Telephone | 857-205-3156
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 8580
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 8580
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 8580
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License Number State | MA
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