Doctor Name: | JACQUELINE MELLISSA VORPAHL |
NPI Number: | 1245417286 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 7426 |
Business Practice Address: | 258 Main St Suite 3 Medfield, MA - 020522041 |
Business Phone Number: | 5082429666 |
Business Fax Number: | 8155728941 |
Mailing Address: | 258 Main St, Suite 3 MEDFIELD |
State: | MA |
Postal Code: | 020522041 |
Phone Number: | 5082429666 |
Fax Number: | 8155728941 |
NPI Enumeration Date: | 01/22/2008 |
NPI Last Update Date: | 01/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 7426 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |