Individual
MARIA D THEODORAKAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-6300
Mailing address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT STREET, BOSTON, MA 02114
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11165
MA
Other
Enumeration date
07/01/2014
Last updated
11/15/2019
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