Provider Demographics
NPI:1255528717
Name:PLESS KAISER, ANICA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANICA
Middle Name:
Last Name:PLESS KAISER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:ANICA
Other - Middle Name:PEARL
Other - Last Name:PLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 NORTON AVE
Mailing Address - Street 2:APT 12
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1259
Mailing Address - Country:US
Mailing Address - Phone:989-506-5643
Mailing Address - Fax:
Practice Address - Street 1:150 S. HUNTINGTON AVE (116B2)
Practice Address - Street 2:VA BOSTON HEALTHCARE SYSTEM
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-2941
Practice Address - Country:US
Practice Address - Phone:857-364-5309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01269103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIPS01269OtherPSYCHOLOGY LICENSE