Individual
DR. JONATHAN JOSHUA ENTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
240 CONCORD AVE, CAMBRIDGE, MA 02138
(617) 702-2733
Mailing address
240 CONCORD AVE, CAMBRIDGE, MA 02138-1337
(617) 702-2733
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
10695
MA
103TP2701X
Group Psychotherapy Psychologist
10695
MA
Other
Enumeration date
03/28/2016
Last updated
08/12/2019
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