Provider Demographics
NPI:1144281734
Name:KENT, SANDRA ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:KENT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 STERLING ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1200
Mailing Address - Country:US
Mailing Address - Phone:774-261-8530
Mailing Address - Fax:508-829-9158
Practice Address - Street 1:45 STERLING ST
Practice Address - Street 2:SUITE 23
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1200
Practice Address - Country:US
Practice Address - Phone:774-261-8530
Practice Address - Fax:508-829-9158
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4763103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical