Provider Demographics
NPI:1669819876
Name:LOFGREN, DONNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:LOFGREN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:PIAZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:212 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-6217
Mailing Address - Country:US
Mailing Address - Phone:781-837-1001
Mailing Address - Fax:
Practice Address - Street 1:529 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2825
Practice Address - Country:US
Practice Address - Phone:508-580-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2596103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical