Individual
DR. ELISHEVA DAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1415 BEACON ST, SUITE #304, BROOKLINE, MA 02446-4816
(617) 738-0780
(617) 566-9314
Mailing address
1415 BEACON ST, SUITE #304, BROOKLINE, MA 02446-4816
(617) 738-0780
(617) 566-9314
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7240
MA
363A00000X
Physician Assistant
696
MA
Other
Enumeration date
01/23/2007
Last updated
11/01/2011
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