Provider Demographics
NPI:1417179797
Name:KAPLAN, MARJORY ANN (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARJORY
Middle Name:ANN
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 NEWBURY STREET
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:508-740-7477
Mailing Address - Fax:
Practice Address - Street 1:45 NEWBURY STREET
Practice Address - Street 2:SUITE 404
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:508-740-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7278103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0500119Medicaid
MA0500119Medicaid