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Individual

MRS. ALEXIS VICHNIAC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
163 ELM ST, 3, SOMERVILLE, MA 02144-3110
(617) 571-8058
Mailing address
163 ELM ST, 3, SOMERVILLE, MA 02144-3110
(617) 571-8058

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
442207 7335
MA

Other

Enumeration date
09/26/2011
Last updated
09/26/2011
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