Individual
CHERYL BETH NISSENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
454 WASHINGTON ST, BROOKLINE, MA 02446-4578
(617) 734-0430
Mailing address
454 WASHINGTON ST, BROOKLINE, MA 02446-4578
(617) 734-0430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115872-SW-LICSW
MA
Other
Enumeration date
09/09/2018
Last updated
09/09/2018
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