Provider Demographics
NPI:1316144470
Name:SHAFFER, HOWARD JEFFREY (PHD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JEFFREY
Last Name:SHAFFER
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 1:27 ALGONQUIN AVE
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5527
Mailing Address - Country:US
Mailing Address - Phone:978-475-0312
Mailing Address - Fax:
Practice Address - Street 1:27 ALGONQUIN AVE
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-5527
Practice Address - Country:US
Practice Address - Phone:978-475-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1922103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical