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General NPI Number Information
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NPI Number | 1205370871
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Entity Type | Individual
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Provider Name | GAL SIVAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 1330 BEACON ST # 202
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City | BROOKLINE
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State | MA
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Zip | 02446-3282
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Country | US
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Telephone | 617-580-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 33 BRAINERD RD APT 311
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City | BOSTON
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State | MA
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Zip | 02134-4527
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Country | US
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Telephone | 617-939-3864
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 10508
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License Number State | MA
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