Doctor Name: | ELEANOR B. PARADISE |
NPI Number: | 1154472652 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1207 |
Business Practice Address: | 10 Langley Rd Suite 401 Newton Centre, MA - 024591972 |
Business Phone Number: | 6179697876 |
Business Fax Number: | 6175581206 |
Mailing Address: | 30 Gammons Rd, WABAN |
State: | MA |
Postal Code: | 024681216 |
Phone Number: | 6173323112 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1207 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |