Individual
DR. LUIS ROBERTO SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 BEACON ST STE 5, BROOKLINE, MA 02446-5587
(617) 516-4076
Mailing address
1101 BEACON ST STE 5, BROOKLINE, MA 02446-5587
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11486
MA
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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