Individual
LISSA MARIE DUTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
2 BREWER ST, CAMBRIDGE, MA 02138-5710
(617) 230-3002
Mailing address
10 CONCORD AVE, CAMBRIDGE, MA 02138-2322
(617) 230-3002
(617) 849-5863
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
TBA
MA
Other
Enumeration date
05/14/2007
Last updated
10/07/2016
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