| Doctor Name: | DR. MARY W HUMPHREY |
| NPI Number: | 1104887298 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 8150 |
| Business Practice Address: | 258 Main St Suite 3 Medfield, MA - 020522041 |
| Business Phone Number: | 5083592570 |
| Business Fax Number: | 5083590175 |
| Mailing Address: | 258 Main St, Suite 3 MEDFIELD |
| State: | MA |
| Postal Code: | 020522041 |
| Phone Number: | 5083592570 |
| Fax Number: | 5083590175 |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 01/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 8150 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |