| Gathering Tank | |
|
42 Lowell Rd Brookline MA 02445-6148 | |
| (617) 701-6073 | |
| Not Available |
| Full Name | Gathering Tank |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 42 Lowell Rd, Brookline, Massachusetts |
| Authorized Official Name and Position | Andre Guillemin (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6077016073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gathering Tank 42 Lowell Rd Brookline MA 02445-6148 Ph: (617) 701-6073 | Gathering Tank 42 Lowell Rd Brookline MA 02445-6148 Ph: (617) 701-6073 |
| NPI Number | 1225852072 |
|---|---|
| Provider Enumeration Date | 11/08/2024 |
| Last Update Date | 11/08/2024 |
| Certification Date | 11/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225852072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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