Individual
CLEMENTE VEGA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
300 LONGWOOD AVE, FEGAN 9, BOSTON, MA 02115-5724
(617) 355-4462
Mailing address
300 LONGWOOD AVE, FEGAN 9, BOSTON, MA 02115-5724
(617) 355-4462
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
3000
CT
103G00000X
Clinical Neuropsychologist
Primary
9201
MA
Other
Enumeration date
02/27/2010
Last updated
07/18/2011
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