Individual
DR. EYDIE I. KASENDORF
Active
Individual
DR. EYDIE I. KASENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6561PR
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011530
BEACON (FALLON)
MA
01
—
329160
HPHC
MA
01
—
735025
TUFTS
MA
01
—
7706437
AETNA
MA
01
—
855201
PACIFICARE
MA
01
—
W05217
BCBS
MA
Enumeration date
11/04/2006
Last updated
11/19/2018
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