Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1073980488 |
---|---|
Provider Name | Asher Lindenbaum |
First Address | Brighton, MA 02135-3680 |
Second Address | Brighton, MA 02135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2015 |
Last Update Date | 29/08/2018 |