Provider Demographics
NPI:1356329031
Name:SOMA, JANIS M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:M
Last Name:SOMA
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 1:106 MARKED TREE RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1634
Mailing Address - Country:US
Mailing Address - Phone:781-444-2735
Mailing Address - Fax:781-444-2735
Practice Address - Street 1:985 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5434
Practice Address - Country:US
Practice Address - Phone:781-849-7157
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2154103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO2326Medicare ID - Type UnspecifiedPSYCHOLOGIST PROVIDER