Individual
DR. SHOSHANA J FAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Mailing address
30 WARREN ST, BRIGHTON, MA 02135-3602
(617) 254-3800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8354
MA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
9952
MA
Other
Enumeration date
05/18/2010
Last updated
04/18/2023
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