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Individual

MARISSA SHALLCROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
120 BOYLSTON STREET, BOSTON, MA 02116
(617) 824-8586
Mailing address
127 JEFFERSON ST, DEDHAM, MA 02026-3613
(617) 824-8586

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NO INSURANCE
Enumeration date
08/16/2018
Last updated
08/16/2018
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