Individual
MARK A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
850 HARRISON AVE, DOWLING 9, BOSTON, MA 02118-4001
(617) 414-1922
(617) 414-5546
Mailing address
771 ALBANY ST, DOWLING 7 NORTH, BOSTON, MA 02118-2525
(617) 414-1922
(617) 638-8542
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MA7431
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0526584
—
MA
Enumeration date
08/07/2006
Last updated
02/11/2011
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