Provider Demographics
NPI:1194842088
Name:ROFFMAN, ARLYN JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARLYN
Middle Name:JANE
Last Name:ROFFMAN
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 1:230 PAYSON RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2834
Mailing Address - Country:US
Mailing Address - Phone:617-484-0955
Mailing Address - Fax:
Practice Address - Street 1:230 PAYSON RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2834
Practice Address - Country:US
Practice Address - Phone:617-484-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3992103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3992OtherMAHEALTHSERVICEPROVIDER
MAW03954OtherBLUE CROSS&BLUE SHIELD