Provider Demographics
NPI:1700895398
Name:KAY, ELLEN LOIS (EDD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:LOIS
Last Name:KAY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WOODSTOCK DRIVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3084
Mailing Address - Country:US
Mailing Address - Phone:508-877-4997
Mailing Address - Fax:508-877-9828
Practice Address - Street 1:8 WOODSTOCK DRIVE
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3084
Practice Address - Country:US
Practice Address - Phone:508-877-4997
Practice Address - Fax:508-877-9828
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4890103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04614Medicare ID - Type Unspecified