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General NPI Number Information
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NPI Number | 1740830728
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Entity Type | Individual
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Provider Name | CRYSTIMARIA KOTSIOPOULOS PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 4238 WASHINGTON ST
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City | ROSLINDALE
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State | MA
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Zip | 02131-2558
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Country | US
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Telephone | 781-790-4497
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Fax | 781-622-9606
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Provider Business Mailing Address
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Address Line | 40 NOUVELLE WAY UNIT N848
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City | NATICK
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State | MA
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Zip | 01760-6512
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Country | US
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Telephone | 781-790-4497
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Fax | 781-622-9606
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY12726
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10000634
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License Number State | MA
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