Individual
DANIELLE DETORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1666 MASSACHUSETTS AVE, SUITE 3, LEXINGTON, MA 02420-5317
(781) 862-6772
Mailing address
1666 MASSACHUSETTS AVE, SUITE 3, LEXINGTON, MA 02420-5317
(781) 862-6772
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
8063
MA
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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