| Xiaoyan Fan Phd Llc | |
|
186 Alewife Brook Pkwy # 1186 Cambridge MA 02138-1121 | |
| (781) 409-1325 | |
| Not Available |
| Full Name | Xiaoyan Fan Phd Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 186 Alewife Brook Pkwy # 1186, Cambridge, Massachusetts |
| Authorized Official Name and Position | Xiaoyan Fan (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7814091325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Xiaoyan Fan Phd Llc 41 Lawrence Ln Belmont MA 02478-3331 Ph: (408) 834-9758 | Xiaoyan Fan Phd Llc 186 Alewife Brook Pkwy # 1186 Cambridge MA 02138-1121 Ph: (781) 409-1325 |
| NPI Number | 1962143966 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Certification Date | 04/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962143966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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