Individual
DR. MARK G FANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
73 ROUNDWOOD RD, NEWTON UPPER FALLS, MA 02464-1218
(617) 969-4040
(617) 795-2065
Mailing address
73 ROUNDWOOD RD, NEWTON, MA 02464-1218
(617) 969-4040
(617) 795-2065
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2215
MA
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
2215
MA
103TA0700X
Adult Development & Aging Psychologist
2215
MA
103TB0200X
Cognitive & Behavioral Psychologist
2215
MA
103TC0700X
Clinical Psychologist
Primary
2215
MA
103TP2701X
Group Psychotherapy Psychologist
2215
MA
106H00000X
Marriage & Family Therapist
2215
MA
Other
Enumeration date
01/26/2006
Last updated
06/29/2009
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