Individual
PAUL EDWARD JANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11 VANDERBILT AVE, SUITE 240, NORWOOD, MA 02062-5056
(781) 769-5050
(781) 784-2927
Mailing address
95 MOOSE HILL PKWY, SHARON, MA 02067-1730
(781) 784-1796
(781) 784-2927
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
864
MA
103TC0700X
Clinical Psychologist
Primary
864
MA
103TF0000X
Family Psychologist
864
MA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
864
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0503576
—
MA
Enumeration date
12/08/2006
Last updated
05/02/2012
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