Individual
SUSAN KAMINSKI FAJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
1 AUTUMN ST, BCH3178, BOSTON, MA 02215-5393
(617) 919-4486
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
10089
MA
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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