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General NPI Number Information
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NPI Number | 1891169454
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Entity Type | Organization
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Legal Business Name | FAMILY WORKS PSYCHOLOGICAL AND ASSESSMENT SERVICES
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 354 W BOYLSTON ST SUITE 224
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City | WEST BOYLSTON
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State | MA
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Zip | 01583-2373
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Country | US
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Telephone | 508-791-1454
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Fax | 508-791-3318
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Provider Business Mailing Address
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Address Line | 354 W BOYLSTON ST SUITE 224
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City | WEST BOYLSTON
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State | MA
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Zip | 01583-2373
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Country | US
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Telephone | 508-791-1454
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Fax | 508-791-3318
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Authorized Official
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Title or Position | OWNER, MANAGING MEMBER
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Name | DR. DANIELLE ANDREA WAHBA
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Credential | PSY.D.
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Telephone | 508-791-1454
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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 | 8302
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License Number State | MA
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