Individual
MS. SOHENGA CHRISPIN DEPESTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 414-5245
(617) 414-5520
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY5000405
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110204010A
—
MA
Enumeration date
09/18/2019
Last updated
12/18/2023
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