Provider Demographics
NPI:1619012325
Name:PADWA, MARSHA A (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:A
Last Name:PADWA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 PRENTICE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1325
Mailing Address - Country:US
Mailing Address - Phone:617-969-1247
Mailing Address - Fax:617-965-1918
Practice Address - Street 1:47 PRENTICE RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1325
Practice Address - Country:US
Practice Address - Phone:617-969-1247
Practice Address - Fax:617-965-1918
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3606103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical