Provider Demographics
NPI:1619995834
Name:SHANDLER, NINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:SHANDLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:SHANDLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:47 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1121
Mailing Address - Country:US
Mailing Address - Phone:413-549-1670
Mailing Address - Fax:
Practice Address - Street 1:47 SUMMER ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1121
Practice Address - Country:US
Practice Address - Phone:413-967-6241
Practice Address - Fax:413-967-9807
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4636103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist