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General NPI Number Information
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NPI Number | 1376916619
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Entity Type | Individual
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Provider Name | GAIL FISKIO M.A.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 1244 CHESTNUT ST
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City | NEWTON
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State | MA
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Zip | 02464-1418
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Country | US
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Telephone | 617-969-8200
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Fax | 617-928-0459
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Provider Business Mailing Address
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Address Line | 104 BENVENUE ST
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City | WELLESLEY
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State | MA
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Zip | 02482-7106
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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 |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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