Individual
KAILA NORMAN MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
165 MIDDLESEX AVE STE 1118, SOMERVILLE, MA 02145-1105
(617) 934-0219
Mailing address
PSC 701 BOX 371, APO, AP 96555-0004
(617) 934-0219
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
10244
MA
103TB0200X
Cognitive & Behavioral Psychologist
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Other
Enumeration date
12/27/2012
Last updated
09/25/2024
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