Doctor Name: | ANDRE PAPAJOHN |
NPI Number: | 1740432475 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.I.C.S.W. |
License Number: | 112208 |
Business Practice Address: | 90 Vandenberg Dr, 66 Mds (afmc) Hanscom Afb, MA - 017312104 |
Business Phone Number: | 7812256789 |
Business Fax Number: | 7812252576 |
Mailing Address: | 90 Vandenberg Dr, 66 Mds (afmc), HANSCOM AFB |
State: | MA |
Postal Code: | 017312104 |
Phone Number: | 7812256789 |
Fax Number: | 7812252576 |
NPI Enumeration Date: | 10/13/2008 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 112208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |