Individual
MARILYN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007965
IL
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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