Individual
DR. PAMELA FANTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
20 CENTRAL ST, SALEM, MA 01970-3739
(781) 639-2359
(978) 745-5455
Mailing address
7 MILL POND, MARBLEHEAD, MA 01945-2686
(781) 639-2359
(978) 745-5455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY4599
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062918000
MAGELLAN
MA
01
—
124611
VALUEOPTIOMS
MA
01
—
713383
TUFTS HEALTH PLAN
MA
01
—
W04460
BCBSMA
—
Enumeration date
01/06/2007
Last updated
07/08/2007
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