Doctor Name: | DR. DONNA L PODOREFSKY |
NPI Number: | 1265512040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6940 |
Business Practice Address: | 1400 Centre St Suite 105 Newton Center, MA - 024592454 |
Business Phone Number: | 6179657034 |
Business Fax Number: | 6179657979 |
Mailing Address: | 1400 Centre St, Suite 105 NEWTON CENTER |
State: | MA |
Postal Code: | 024592454 |
Phone Number: | 6179657034 |
Fax Number: | 6179657979 |
NPI Enumeration Date: | 10/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6940 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |