Doctor Name: | KEVIN C FLYNN |
NPI Number: | 1295771327 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 1791 |
Business Practice Address: | 115 Main St Suite 2d North Easton, MA - 023561468 |
Business Phone Number: | 5082387766 |
Business Fax Number: | 5082305089 |
Mailing Address: | 115 Main St, Suite 2d NORTH EASTON |
State: | MA |
Postal Code: | 023561468 |
Phone Number: | 5082387766 |
Fax Number: | 5082305089 |
NPI Enumeration Date: | 06/20/2006 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1791 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |