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Individual

MARISSA ALERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
111 OCEAN ST, BOSTON, MA 02124-3626
(410) 550-7988
Mailing address
1 WASHINGTON MALL # 1261, BOSTON, MA 02108-2616
(617) 249-3199

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY5000522
MA

Other

Enumeration date
07/18/2017
Last updated
09/28/2023
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