Individual
BERNI ZISSERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
151 MYSTIC AVE, SUITE SIX, MEDFORD, MA 02155-4632
(781) 396-1199
(781) 396-1439
Mailing address
151 MYSTIC AVE, SUITE SIX, MEDFORD, MA 02155-4632
(781) 396-1199
(781) 396-1439
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101979
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101979
LICENSE
MA
Enumeration date
10/13/2010
Last updated
10/13/2010
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