Individual
ALEXANDRIA VANOVERBERGHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
77 RUMFORD AVE, WALTHAM, MA 02453-3872
(781) 894-4325
Mailing address
77 RUMFORD AVE, WALTHAM, MA 02453-3872
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW2120390
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/14/2023
Last updated
12/05/2024
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