Individual
MS. JOAN DITZION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6 BELLEVUE AVE, CAMBRIDGE, MA 02140-3614
(617) 864-9305
Mailing address
6 BELLEVUE AVE, CAMBRIDGE, MA 02140-3614
(617) 864-9305
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1017875
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P05294
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/18/2007
Last updated
12/18/2007
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