Individual
DR. IDIA BINITIE THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(857) 218-5399
Mailing address
19 HALIFAX ST, BOSTON, MA 02130-4306
(813) 789-1361
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
9520
MA
103TH0100X
Health Service Psychologist
Primary
9520
MA
Other
Enumeration date
08/06/2007
Last updated
06/08/2012
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