Individual
DEIRDRE FAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
23 MAIN ST, CTR INTEGRATIVE HEALING 2ND FLOOR, WATERTOWN, MA 02472-4403
(617) 923-1930
Mailing address
23 MAIN STREET, CTR INTEGRATIVE HEALING 2ND FLOOR, WATERTOWN, MA 02472
(617) 923-1930
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1030818
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
406008
TUFTS HEALTH PLAN
MA
Enumeration date
12/05/2006
Last updated
07/08/2007
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