Individual
DR. ELLEN FAHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
45 S ORLEANS RD, ORLEANS, MA 02653-2422
(607) 769-0837
Mailing address
PO BOX 806, ORLEANS, MA 02653-0806
(607) 769-0837
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
10307
MA
103TH0100X
Health Service Psychologist
Primary
10307
MA
103TS0200X
School Psychologist
10307
MA
Other
Enumeration date
03/19/2007
Last updated
04/02/2016
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