Individual
CHRISTINA SUPELANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
160 COMMONWEALTH AVE STE U3, BOSTON, MA 02116-2749
(617) 259-1895
Mailing address
160 COMMONWEALTH AVE STE U3, BOSTON, MA 02116-2749
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11197
MA
Other
Enumeration date
08/12/2019
Last updated
11/03/2019
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