Soren R. Ekstrom, Inc. | |
29 Chester St Watertown MA 02472-4002 | |
(617) 923-6086 | |
Not Available |
Full Name | Soren R. Ekstrom, Inc. |
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Speciality | Psychologist - Clinical |
Location | 29 Chester St, Watertown, Massachusetts |
Authorized Official Name and Position | Soren R. Ekstrom (SOLE PROPIETOR) |
Authorized Official Contact | 6179236086 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Soren R. Ekstrom, Inc. 29 Chester St Watertown MA 02472-4002 Ph: (617) 923-6086 | Soren R. Ekstrom, Inc. 29 Chester St Watertown MA 02472-4002 Ph: (617) 923-6086 |
NPI Number | 1134421902 |
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Provider Enumeration Date | 11/29/2010 |
Last Update Date | 11/29/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134421902 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 3505 (Massachusetts) | Primary |
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