Individual
MR. ALLEN MARK SPIVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
55 DIMOCK ST, ROOM 309, ROXBURY, MA 02119-1029
(617) 442-8800
(617) 427-1126
Mailing address
55 DIMOCK ST, ROOM 309, ROXBURY, MA 02119-1029
(617) 442-8800
(617) 427-1126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1029802
MA
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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