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General NPI Number Information
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NPI Number | 1104757343
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Entity Type | Organization
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Legal Business Name | INNER WISDOM PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 23 WEST ST # 2
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City | MEDFORD
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State | MA
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Zip | 02155-4340
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Country | US
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Telephone | 216-548-7587
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Fax |
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Provider Business Mailing Address
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Address Line | 165 MIDDLESEX AVE # 1211
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City | SOMERVILLE
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State | MA
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Zip | 02145-1105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIANNE MOSKOWITZ
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Credential | LMHC, ATR
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Telephone | 216-548-7587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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