| Dr Jodi Coochise Llc | |
|
399 Boylston St Ste 900a Boston MA 02116-3305 | |
| (617) 674-0061 | |
| (617) 674-2144 |
| Full Name | Dr Jodi Coochise Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 399 Boylston St Ste 900a, Boston, Massachusetts |
| Authorized Official Name and Position | Jodi Coochise (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 6176740061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jodi Coochise Llc 83 Paul Gore St Apt 3 Jamaica Plain MA 02130-1858 Ph: (303) 807-1147 | Dr Jodi Coochise Llc 399 Boylston St Ste 900a Boston MA 02116-3305 Ph: (617) 674-0061 |
| NPI Number | 1124614987 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 12/16/2020 |
| Certification Date | 12/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124614987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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