Individual
DEBORAH LYNNE BLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7 HARRIS AVE, JAMAICA PLAIN, MA 02130-2888
(617) 522-3911
Mailing address
7 HARRIS AVE, JAMAICA PLAIN, MA 02130-2888
(617) 522-3911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6482
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DBW05161
B. CROSS IND. PROVIDER ID
MA
01
—
W10457
BLUE CROSS BILLING ID
MA
Enumeration date
07/24/2006
Last updated
07/08/2007
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