Provider Demographics
NPI:1194779314
Name:WOLMAN, RICHARD N (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:N
Last Name:WOLMAN
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 1:99 SUMMER ST
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-1213
Mailing Address - Country:US
Mailing Address - Phone:617-439-4700
Mailing Address - Fax:
Practice Address - Street 1:99 SUMMER ST
Practice Address - Street 2:SUITE 1600
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1213
Practice Address - Country:US
Practice Address - Phone:617-439-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA994103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist