Individual
NATALIE C. DATTILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., MHA
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
10949
MA
103TC0700X
Clinical Psychologist
20042360A
IN
103TC0700X
Clinical Psychologist
99036092A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200958110
—
IN
Enumeration date
07/24/2009
Last updated
03/29/2019
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