Individual
DR. SUSAN ELLEN WAISBREN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 LONGWOOD AVE, FEGAN 10, BOSTON, MA 02115-5724
(617) 355-4686
(617) 730-0907
Mailing address
1 AUTUMN ST, SUITE 525, BOSTON, MA 02215-5393
(617) 355-4686
(617) 730-0907
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 2749 PR
MA
Other
Enumeration date
06/04/2006
Last updated
07/08/2007
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