Provider Demographics
NPI:1760554349
Name:WOY, J RICHARD (PHD)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:RICHARD
Last Name:WOY
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 1:138B SEWALL AVE.
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446
Mailing Address - Country:US
Mailing Address - Phone:617-731-9852
Mailing Address - Fax:617-731-5246
Practice Address - Street 1:138B SEWALL AVE.
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-731-9852
Practice Address - Fax:617-731-5246
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3140103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical