Healthcare Provider Details

I. General information

NPI: 1396924007
Provider Name (Legal Business Name): DEVIN GEORGE ATALLAH PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DEVIN GEORGE ATALLAH PHD

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 870007
MILTON VILLAGE MA
02187-0007
US

IV. Provider business mailing address

PO BOX 870007
MILTON VILLAGE MA
02187-0007
US

V. Phone/Fax

Practice location:
  • Phone: 617-237-6675
  • Fax:
Mailing address:
  • Phone: 617-237-6675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: