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Individual

DR. NICOLINA MARIE FEDELE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
36 STONEBRIDGE RD, WAYLAND, MA 01778-3023
(508) 655-4517
(508) 655-4517
Mailing address
36 STONEBRIDGE RD, WAYLAND, MA 01778-3023
(508) 655-4517
(508) 655-4517

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3522
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
644665
HPHC
MA
01
718017
TUFTS
MA
01
W03457
BCBS
MA
Enumeration date
04/12/2006
Last updated
10/21/2011
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