# EAVAN MILES-MASON, PHD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518575786
- **Authorized official:** DR. EAVAN DURWIN (PEDIATRIC NEUROPSYCHOGIST)
- **Authorized official phone:** (978) 493-2848

## Contact information

- **Practice address:** 747 MAIN ST \# 228, CONCORD, MA 01742-3302
- **Practice address phone:** (978) 493-2848
- **Mailing address:** 747 MAIN ST \# 228, CONCORD, MA 01742-3302
- **Mailing address phone:** (978) 493-2848

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2020
- **Last updated:** 10/04/2022