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Organization
WEDIKO CHILDREN'S SERVICES
Active
Organization
WEDIKO CHILDREN'S SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CLONTZ MSW (PROGRAM DIRECTOR)
(617) 292-9200
Entity
Organization
Contact information
Practice address
72 E DEDHAM ST, BOSTON, MA 02118-2315
(617) 292-9200
(617) 292-9272
Mailing address
72 E DEDHAM ST, BOSTON, MA 02118-2315
(617) 292-9200
(617) 292-9272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/08/2009
Last updated
06/08/2015
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