Provider Demographics
NPI:1538650601
Name:DOERFLER, LEONARD ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ANTHONY
Last Name:DOERFLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PINEDALE RD
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3502
Mailing Address - Country:US
Mailing Address - Phone:508-754-9537
Mailing Address - Fax:
Practice Address - Street 1:26 PINEDALE RD
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3502
Practice Address - Country:US
Practice Address - Phone:508-754-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4267103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral