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Individual

DIEUMY PHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
300 THE FENWAY, BOSTON, MA 02115-5820
(617) 521-3943
Mailing address
25 MOUNT VERNON ST # 1, DORCHESTER, MA 02125-1604
(857) 544-3619

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
116947
MA

Other

Enumeration date
09/25/2018
Last updated
09/25/2018
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