Provider Demographics
NPI:1467893453
Name:PALLIS, CLARE (MED, CAGS)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:PALLIS
Suffix:
Gender:F
Credentials:MED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BRIARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1752
Mailing Address - Country:US
Mailing Address - Phone:508-918-3857
Mailing Address - Fax:617-488-2224
Practice Address - Street 1:13 MAIN ST
Practice Address - Street 2:SUITE 8A
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1946
Practice Address - Country:US
Practice Address - Phone:508-918-3857
Practice Address - Fax:617-488-2224
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health