Individual
MS. VIRGINIA DIANE PEISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.SC.
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
11670
MA
Other
Enumeration date
04/26/2019
Last updated
08/19/2022
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