Provider Demographics
NPI:1518214147
Name:MARJORIE G. WELSH, LLC.
Entity Type:Organization
Organization Name:MARJORIE G. WELSH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:508-989-6859
Mailing Address - Street 1:20 TREMONT ST
Mailing Address - Street 2:SUITE 31
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5310
Mailing Address - Country:US
Mailing Address - Phone:508-989-6859
Mailing Address - Fax:
Practice Address - Street 1:20 TREMONT ST
Practice Address - Street 2:SUITE 31
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5310
Practice Address - Country:US
Practice Address - Phone:508-989-6859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty