Provider Demographics
NPI:1346356979
Name:DOGAN, NAOMI MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:MICHELLE
Last Name:DOGAN
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 1:200 GREAT RD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2711
Mailing Address - Country:US
Mailing Address - Phone:781-275-1800
Mailing Address - Fax:
Practice Address - Street 1:200 GREAT RD
Practice Address - Street 2:SUITE 232
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2711
Practice Address - Country:US
Practice Address - Phone:781-275-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7934103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7934OtherLICENSED PSYCHOLOGIST