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Organization

TRUSTEES OF TUFTS COLLEGE

Active
Parent organization
TRUSTEES OF TUFTS COLLEGE
Other names
Craniofacial Pain Clinic-Behavioral Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRUSTEES OF TUFTS COLLEGE
Authorized official
LISA GATELY (CREDENTIALING MANAGER)
(617) 636-6505
Entity
Organization

Contact information

Practice address
1 KNEELAND ST FL 6, BOSTON, MA 02111-1527
(617) 636-6817
Mailing address
200 HARRISON AVE FL 2, BOSTON, MA 02111-1836
(617) 636-0451

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
06/15/2018
Last updated
06/15/2018
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