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Individual

MICHAEL BASSECHES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
19 BELLFLOWER ST, LEXINGTON, MA 02421-6505
(781) 652-8697
Mailing address
19 BELLFLOWER ST, LEXINGTON, MA 02421-6505
(781) 652-8697

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3627
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W03704
BLUE SHIELD
MA
Enumeration date
06/14/2006
Last updated
07/08/2007
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