MEDICARE: DR. ALLYSON TATEM KLAY PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	8221	MA

General Provider Information

NPI Number	:	1124141262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLYSON TATEM KLAY PSYD

Provider Business Mailing Address
First Line	:	81 WASHINGTON ST
Second Line	:	SUITE 35
City	:	SALEM
State	:	MA
Zip	:	01970-3595
Country	:	US
Telephone Number	:	978-590-4443
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 WASHINGTON ST
Second Line	:	SUITE 35
City	:	SALEM
State	:	MA
Zip	:	01970-3595
Country	:	US
Telephone Number	:	978-590-4443
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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