Provider Demographics
NPI:1023190675
Name:DOWDEN, SHAUNA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:LYNN
Last Name:DOWDEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4712
Mailing Address - Country:US
Mailing Address - Phone:617-855-2560
Mailing Address - Fax:781-646-1191
Practice Address - Street 1:754 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4712
Practice Address - Country:US
Practice Address - Phone:617-855-2560
Practice Address - Fax:781-646-1191
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY 8018-PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06168OtherBLUE CROSS BLUE SHIELD NO