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Individual

DR. JUSTIN LEO ENGGASSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
150 S. HUNTINGTON AVENUE, VA BOSTON HEALTHCARE SYSTEM (116B), BOSTON, MA 02130
(774) 826-1380
Mailing address
150 S. HUNTINGTON AVENUE, VA BOSTON HEALTHCARE SYSTEM (116B), BOSTON, MA 02130
(774) 826-1380

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
8807
MA
103TB0200X
Cognitive & Behavioral Psychologist
8807
MA
103TC0700X
Clinical Psychologist
Primary
8807
MA

Other

Enumeration date
08/05/2007
Last updated
01/07/2008
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