Healthcare Provider Details
I. General information
NPI: 1568390516
Provider Name (Legal Business Name): HEATHER CORAZZINI PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
99 WASHINGTON ST UNIT 204
MELROSE MA
02176-6028
US
IV. Provider business mailing address
99 WASHINGTON ST UNIT 204
MELROSE MA
02176-6028
US
V. Phone/Fax
- Phone: 781-790-3743
- Fax:
- Phone: 781-790-3743
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HEATHER
CORAZZINI
Title or Position: OWNER
Credential: PSYD
Phone: 781-790-3743