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General NPI Number Information
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NPI Number | 1689402083
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Entity Type | Organization
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Legal Business Name | THE EXPERT ALLY LLC
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 124 WATERTOWN ST STE 3A EAST
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City | WATERTOWN
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State | MA
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Zip | 02472-2599
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Country | US
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Telephone | 617-651-1927
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CLINTON RD
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City | BROOKLINE
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State | MA
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Zip | 02445-5812
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Country | US
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Telephone | 781-820-6764
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | DR. YULIKA FORMAN
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Credential | PHD
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Telephone | 781-820-6764
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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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