Organization
BROOKLINE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGINIA A BYRON EDD (ADMINISTRATIVE DIRECTOR)
(617) 734-2007
Entity
Organization
Contact information
Practice address
9 BABCOCK ST, BROOKLINE, MA 02446-5903
(617) 734-2007
(617) 734-7165
Mailing address
9 BABCOCK ST, BROOKLINE, MA 02446-5903
(617) 734-2007
(617) 734-7165
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3098
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W10149
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/13/2006
Last updated
08/22/2020
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