Doctor Name: | MARCIA LEA GALVINHILL |
NPI Number: | 1912013970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6048 |
Business Practice Address: | 148 Worcester St West Boylston, MA - 015831751 |
Business Phone Number: | 5083539157 |
Business Fax Number: | |
Mailing Address: | 12 Watson Ln, RUTLAND |
State: | MA |
Postal Code: | 015431346 |
Phone Number: | 7742340125 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 04/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |