Provider Demographics
NPI:1811480924
Name:KEHOE, NANCY CLARE (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:CLARE
Last Name:KEHOE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUSHING ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4584
Mailing Address - Country:US
Mailing Address - Phone:617-417-9788
Mailing Address - Fax:
Practice Address - Street 1:100 CUSHING ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4584
Practice Address - Country:US
Practice Address - Phone:617-417-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2182103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist