Individual
LIANA GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5766
(617) 636-4852
Mailing address
60 CHESTNUT ST APT 1, BROOKLINE, MA 02445-7865
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3016290
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2024
Last updated
03/28/2024
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