Individual
JOHANNE ELIACIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
150 S HUNTINGTON AVE, BOSTON, MA 02130-4817
(857) 364-5647
Mailing address
1124 BLACK RIDGE CT, BROWNSBURG, IN 46112-9149
(781) 308-7233
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042767A
IN
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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