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Individual

DR. NILLA M ORTHEN-GAMBILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5 ESSEX GREEN DRIVE, SUITE 22, PEABODY, MA 01960
(978) 531-5517
(617) 489-2645
Mailing address
5 ESSEX GREEN DR, SUITE 22, PEABODY, MA 01960-2929
(978) 531-5517
(617) 489-2645

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PR7729
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
238676000
MAGELLAN
MA
01
W05965
BCBS
MA
Enumeration date
01/26/2007
Last updated
04/01/2013
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