Individual
MS. NANCY RUTH CETLIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
264 BEACON ST, FOURTH FLOOR, BOSTON, MA 02116
(617) 267-5433
(617) 782-6764
Mailing address
141 BROOKS ST, UNIT 1, BRIGHTON, MA 02135
(617) 254-0284
(617) 782-6764
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3514
MA
103TC0700X
Clinical Psychologist
6301002901
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001020601
MANAGED HEALTH NETWORK
—
01
—
0012255000
AETNA
—
01
—
6883946
VALUE/OPTIONS
—
01
—
739159
TUFTS HEALTH PLAN
—
01
—
A002908
VAL/H
—
01
—
VD6841
EMPIRE BCBS
—
01
—
W03627
BLUE CROSS
MA
Enumeration date
02/23/2006
Last updated
07/08/2007
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