Edwin D Boudreaux is a Clinical in Boston, Massachusetts. Edwin D Boudreaux practices all healthcare services and medical treatments related to Clinical. The NPI Number for Edwin D Boudreaux is 1790873768. The last update date is 2017-01-25.
Edwin D Boudreaux's current location address is Po Box 415348, Boston, Massachusetts. You can contact this provider via phone number 8002258885 and fax number 5083341977. The mailing address for Edwin D Boudreaux is Po Box 415348, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Edwin D Boudreaux |
|---|---|
| Address | Po Box 415348, Boston, Massachusetts |
| Phone Number | 8002258885 |
| Fax Number | 5083341977 |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1790873768 |
|---|---|
| Provider Enumeration Date | 2006-10-11 |
| Last Updated Date | 2017-01-25 |
Provider Mailing Address Detail
| Address | Po Box 415348 |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 22415348 |
| Phone Number | 8002258885 |
| Fax Number | 5083341977 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 9227 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1663773 | AMERIHEALTH PPO | ||
| 476594000 | MAGELLAN | ||
| 7663465 | AETNA | ||
| 3K6039 | HEALTHNET | ||
| 42304 | UNIVERSITY HEALTHPLAN | ||
| 2321722000 | AMERIHEALTH HMO, KEYSTONE, IBC | ||
| 8879800 | NJ | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Edwin D Boudreaux?
The Edwin D Boudreaux has been issued the NPI (National Provider Identifier) 1790873768 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Edwin D Boudreaux is physically located?
The Edwin D Boudreaux is physically situated at the following address: Po Box 415348, Boston, MA, 22415348.
What is Edwin D Boudreaux's specialized field of practice, and what is the corresponding taxonomy classification code?
The Edwin D Boudreaux's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date did the Edwin D Boudreaux receive the assignment of its 1790873768 from the Centers for Medicare & Medicaid Services?
The Edwin D Boudreaux was issued its 1790873768 by the Centers for Medicare & Medicaid Services on 2006-10-11.
When was the information regarding Edwin D Boudreaux, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Edwin D Boudreaux, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2017-01-25.