Healthcare Provider Details

I. General information

NPI: 1811148117
Provider Name (Legal Business Name): RHEA DENISE ANTONIO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BEACON ST BOSTON INSTITUTE FOR PSYCHOTHERAPY
BROOKLINE MA
02446-4816
US

IV. Provider business mailing address

5 SILVER MINE LN
GEORGETOWN MA
01833-1601
US

V. Phone/Fax

Practice location:
  • Phone: 617-566-7914
  • Fax: 617-278-0200
Mailing address:
  • Phone: 978-618-3419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: