Individual
MARIA L IACOBBO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
30 CHURCH ST, SUITE 200, BELMONT, MA 02478-4900
(617) 484-1616
Mailing address
30 CHURCH ST, SUITE 200, BELMONT, MA 02478-4900
(617) 484-1616
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2149
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W02290
BCBS
MA
Enumeration date
05/27/2006
Last updated
07/08/2007
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