Individual
DR. BRYAN P IANDOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
881 SOUTH ST, SUITE #5, FITCHBURG, MA 01420-6252
(978) 343-4747
(978) 343-4729
Mailing address
33 ELECTRIC AVE, SUITE 205, FITCHBURG, MA 01420-7954
(978) 343-4747
(978) 343-4729
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6208
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521744
—
MA
Enumeration date
11/24/2006
Last updated
05/12/2015
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