Individual
MARY BETH LEAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
537 ROUTE 28, STE 2G, HARWICH PORT, MA 02646-1894
(508) 430-8672
(508) 430-9821
Mailing address
8 SHOAL HOPE DR, WEST HARWICH, MA 02671-1615
(508) 430-8672
(508) 430-9821
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6839
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501514
—
MA
Enumeration date
05/27/2005
Last updated
07/08/2007
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