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General NPI Number Information
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NPI Number | 1992128086
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Entity Type | Organization
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Legal Business Name | STREFF ASSOCIATES
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 532 GREAT RD
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City | ACTON
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State | MA
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Zip | 01720-3415
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Country | US
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Telephone | 978-263-0439
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Fax | 978-486-3140
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Provider Business Mailing Address
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Address Line | 532 GREAT RD
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City | ACTON
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State | MA
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Zip | 01720-3415
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Country | US
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Telephone | 978-263-0439
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Fax | 978-486-3140
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | DR. CHARLES EDWARD STREFF
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Credential | PH.D.
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Telephone | 978-263-0439
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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 | 2084
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License Number State | MA
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