Provider Demographics
NPI:1114048774
Name:GAMER, ENID JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ENID
Middle Name:JANE
Last Name:GAMER
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:PO BOX 870004
Mailing Address - Street 2:
Mailing Address - City:MILTON VILLAGE
Mailing Address - State:MA
Mailing Address - Zip Code:02187-0181
Mailing Address - Country:US
Mailing Address - Phone:617-696-1709
Mailing Address - Fax:
Practice Address - Street 1:75 ADAMS ST
Practice Address - Street 2:SUITE H
Practice Address - City:MILTON VILLAGE
Practice Address - State:MA
Practice Address - Zip Code:02187-0181
Practice Address - Country:US
Practice Address - Phone:617-696-1709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA454103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist