Healthcare Provider Details

I. General information

NPI: 1316780893
Provider Name (Legal Business Name): DHRITI SEHGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 MAIN ST
WALTHAM MA
02451-0602
US

IV. Provider business mailing address

76 BAY STATE RD APT 1
BOSTON MA
02215-1984
US

V. Phone/Fax

Practice location:
  • Phone: 781-893-2003
  • Fax:
Mailing address:
  • Phone: 857-313-0404
  • 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: