Individual
ALLYN ST. LIFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
93 UNION ST, SUITE 319B, NEWTON CENTRE, MA 02459-2244
(617) 527-5004
(617) 527-4727
Mailing address
75 GARLAND RD, NEWTON CENTRE, MA 02459-1741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1021709
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104688
MAGELLAN
MA
01
—
732286
TUFTS HEALTH PLAN
MA
01
—
P06386
BCBSMA
MA
Enumeration date
09/20/2006
Last updated
07/08/2007
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