Healthcare Provider Details

I. General information

NPI: 1275243073
Provider Name (Legal Business Name): INTEGRATION LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LIBERTY SQ # 2274
BOSTON MA
02109-5800
US

IV. Provider business mailing address

6 LIBERTY SQ # 2274
BOSTON MA
02109-5800
US

V. Phone/Fax

Practice location:
  • Phone: 617-871-9877
  • Fax:
Mailing address:
  • Phone: 617-871-9877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: EMILIA SABATOWSKA
Title or Position: PSYCHOTHERAPIST
Credential:
Phone: 617-871-9877