Individual
MR. MARCEL FAJNZYLBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
1141 BEACON ST, BROOKLINE, MA 02446-5528
(617) 277-9400
(617) 879-0325
Mailing address
1871 BEACON ST, BROOKLINE, MA 02445-4274
(617) 734-5243
(617) 879-0325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
03502
MA
103TC0700X
Clinical Psychologist
03502
MA
103TC1900X
Counseling Psychologist
03502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0517607
—
MA
Enumeration date
08/09/2006
Last updated
12/29/2014
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