Individual
ALICE DIANE DOMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
130 2ND AVE, BOSTON IVF - DOMAR CENTER, WALTHAM, MA 02451-1100
(781) 434-6578
(781) 370-2330
Mailing address
130 2ND AVE, BOSTON IVF - DOMAR CENTER, WALTHAM, MA 02451-1100
(781) 434-6578
(781) 370-2330
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
4308
MA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
4308
MA
103TC0700X
Clinical Psychologist
4308
MA
103TC1900X
Counseling Psychologist
4308
MA
103TF0000X
Family Psychologist
4308
MA
103TH0100X
Health Service Psychologist
4308
MA
103TP2701X
Group Psychotherapy Psychologist
4308
MA
Other
Enumeration date
05/23/2006
Last updated
09/01/2009
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