Individual
ANDREW UNTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
330 MOUNT AUBURN ST, CLARK 1, CAMBRIDGE, MA 02138-5502
(617) 499-5054
(617) 499-5465
Mailing address
330 MOUNT AUBURN ST, CLARK 1, CAMBRIDGE, MA 02138-5502
(617) 499-5054
(617) 499-5465
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7452
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W06479
BLUE CROSS
MA
Enumeration date
11/17/2006
Last updated
03/26/2010
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