Individual
DR. DALE E DILLAVOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
545 CONCORD AVE, SUITE 20, CAMBRIDGE, MA 02138
(617) 499-9977
Mailing address
25 NORTH HANCOCK ST, LEXINGTON, MA 02420-3406
(781) 862-2576
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3613
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3310
AMERICAN ACADEMY OF HEALT
—
01
—
34261
NATL REG OF HEALTH CARE P
—
Enumeration date
01/29/2007
Last updated
07/08/2007
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