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Individual

MR. DAVID STUART DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LICSW

Contact information

Practice address
279 MASSACHUSETTS AVE, ARLINGTON, MA 02474-8302
(781) 777-1726
Mailing address
279 MASSACHUSETTS AVE, ARLINGTON, MA 02474-8302
(617) 571-5194

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1018400
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PO5220
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/19/2007
Last updated
07/08/2007
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