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Individual

DEBORAH MAX REISMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
151 MYSTIC AVE, SUITE SIX, MEDFORD, MA 02155-4632
(781) 396-1199
(781) 396-1439
Mailing address
75 BEETHOVEN AVE, WABAN, MA 02468-1732
(617) 332-3980

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106645
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P04193
BCBS
MA
Enumeration date
09/20/2006
Last updated
11/28/2011
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