Craniofacial Pain Clinic-behavioral Health | |
1 Kneeland St Fl 6 Boston MA 02111-1527 | |
(617) 636-6817 | |
Not Available |
Full Name | Craniofacial Pain Clinic-behavioral Health |
---|---|
Speciality | Psychologist |
Location | 1 Kneeland St Fl 6, Boston, Massachusetts |
Authorized Official Name and Position | Lisa Gately (CREDENTIALING MANAGER) |
Authorized Official Contact | 6176366505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Craniofacial Pain Clinic-behavioral Health 200 Harrison Ave Fl 2 Boston MA 02111-1836 Ph: (617) 636-0451 | Craniofacial Pain Clinic-behavioral Health 1 Kneeland St Fl 6 Boston MA 02111-1527 Ph: (617) 636-6817 |
NPI Number | 1609360510 |
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Provider Enumeration Date | 06/15/2018 |
Last Update Date | 06/15/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609360510 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
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