Individual
DR. THILO DECKERSBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
55 FRUIT ST, 149-2611, BOSTON, MA 02114-2621
(617) 724-6300
(617) 726-7541
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8233
MA
Other
Enumeration date
12/20/2005
Last updated
07/08/2007
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