Individual
JOHN P RAFTERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
116 WHITCOMB AVE, BOSTON, MA 02130
(617) 524-3070
(617) 327-9594
Mailing address
116 WHITCOMB AVE, BOSTON, MA 02130
(617) 524-3070
(617) 327-9594
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
124
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1852256
—
MA
01
—
1892002
MA-BEH-HEALTH
—
Enumeration date
09/01/2006
Last updated
07/08/2007
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