Individual
DR. SEBASTIAN JAMES BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
940 BELMONT ST BLDG 5, BROCKTON, MA 02301-5596
(774) 826-3510
Mailing address
940 BELMONT ST BLDG 5, BROCKTON, MA 02301-5596
(774) 826-3510
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
023720
NY
103TC0700X
Clinical Psychologist
38389
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/20/2018
Last updated
10/16/2020
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