Organization
SOREN R. EKSTROM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOREN R. EKSTROM PH.D. (SOLE PROPIETOR)
(617) 923-6086
Entity
Organization
Contact information
Practice address
29 CHESTER ST, WATERTOWN, MA 02472-4002
(617) 923-6086
Mailing address
29 CHESTER ST, WATERTOWN, MA 02472-4002
(617) 923-6086
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3505
MA
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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