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General NPI Number Information
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NPI Number | 1124633565
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTEGRATIVE HEALTH
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Dates
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Enumeration Date | 09/12/2020
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 231 LOWELL ST # 1
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City | WALTHAM
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State | MA
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Zip | 02453-5020
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Country | US
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Telephone | 617-812-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 231 LOWELL ST # 1
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City | WALTHAM
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State | MA
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Zip | 02453-5020
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Country | US
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Telephone | 617-812-2232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLIE ELISABETH KING
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Credential |
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Telephone | 617-812-2232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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