Individual
DR. MARY ELLEN MENKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
720 HARRISON AVE, BOSTON, MA 02118-2371
(617) 638-7428
(617) 638-7472
Mailing address
720 HARRISON AVE, BOSTON, MA 02118-2371
(617) 638-7428
(617) 638-7472
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7594
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501590
—
MA
Enumeration date
03/06/2007
Last updated
07/08/2007
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