Individual
SUSAN WINICKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
330 MOUNT AUBURN ST, CLARK 1, CAMBRIDGE, MA 02138-5502
(617) 499-5054
(617) 499-5654
Mailing address
330 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5502
(617) 499-5054
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1553
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W01701
BLUE CROSS
MA
Enumeration date
01/04/2007
Last updated
01/05/2010
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