Organization
BOSTON BEHAVIOR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY VANDERMERWE (OFFICE MANAGER)
(603) 580-2337
Entity
Organization
Contact information
Practice address
300 TRADE CENTER 100 SYLVAN RD, SUITE 7790, WOBURN, MA 01801-1883
(781) 281-0213
(781) 281-0764
Mailing address
300 TRADE CENTER 100 SYLVAN RD, SUITE 7790, WOBURN, MA 01801-1883
(781) 281-0213
(781) 281-0764
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4233
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104053933
SOLO NPI
MA
01
—
1124356233
SOLO NPI
MA
Enumeration date
06/29/2010
Last updated
08/05/2010
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