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Individual

DR. MELINDA EILEEN KULISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1679 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138-1877
(617) 492-2841
(617) 492-1079
Mailing address
7 FAIRVIEW AVE, ARLINGTON, MA 02474-1215
(781) 643-4969

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
7822
MA
103TC0700X
Clinical Psychologist
Primary
7822
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W06157
BCBS OF MA INDEMNITY
MA
Enumeration date
12/02/2006
Last updated
12/19/2011
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