Individual
DR. TEODOLINDA WAYSHAK PIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
100 MERRIMACK ST, SUITE 205-F, LOWELL, MA 01852-1708
(510) 332-1819
Mailing address
35 RIVERWALK WAY UNIT 108, LOWELL, MA 01854-3651
(510) 332-1819
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
9449
MA
103TC0700X
Clinical Psychologist
Primary
9449
MA
103TC0700X
Clinical Psychologist
PSY19127
CA
Other
Enumeration date
09/22/2011
Last updated
03/22/2019
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