Basic Information
| Provider Information | |||||||||
| NPI: | 1740684877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAZEL | ||||||||
| FirstName: | SASHEEN | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1261 FURNACE BROOK PKWY | ||||||||
| Address2: | STE 31 | ||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021694787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176318754 | ||||||||
| FaxNumber: | 7818941195 | ||||||||
| Practice Location | |||||||||
| Address1: | 1261 FURNACE BROOK PKWY STE 30 | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021694721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174794545 | ||||||||
| FaxNumber: | 6174794555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2014 | ||||||||
| LastUpdateDate: | 07/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | N | Behavioral Health & Social Service Providers | Psychologist | 103T00000X | 10589 | MA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.