Individual
DR. MARSHA VANNICELLI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
545 CONCORD AVE, CAMBRIDGE, MA 02138-1125
(617) 499-9992
(617) 876-0199
Mailing address
545 CONCORD AVE, CAMBRIDGE, MA 02138-1125
(617) 499-9992
(617) 876-0199
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
318
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W01353
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/06/2006
Last updated
07/08/2007
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