Individual
DR. PATRICIO DHIMITRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
599 CANAL ST, LAWRENCE, MA 01840-1244
(978) 687-6488
(978) 687-4511
Mailing address
599 CANAL ST, LAWRENCE, MA 01840-1244
(978) 687-6488
(978) 687-4511
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2431
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0507962
—
MA
01
—
WO2659
BLUE SHIELD
MA
Enumeration date
04/04/2007
Last updated
09/07/2012
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