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Individual

MR. PHILIP JOHN DETSCH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
157 UNION ST, MARLBOROUGH, MA 01752
(508) 486-5542
(508) 486-5508
Mailing address
45 SAMUEL PRESCOTT DR, STOW, MA 01775
(978) 897-8912

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111984
MA

Other

Enumeration date
04/05/2006
Last updated
07/08/2007
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