Individual
ELIZABETH CANICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
77 WARREN ST, BRIGHTON, MA 02135-3601
(617) 562-5567
(617) 562-5564
Mailing address
77 WARREN ST FL 3, BRIGHTON, MA 02135-3601
(617) 562-5485
(617) 562-5415
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4302
MA
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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