Individual provider · Type 1 NPI

Mark A. Deyab, LICSW

Mental Health Counselor · Waltham, MA

NPI number 1104907732 Active

Practice location

20 Hope Ave, G-05
Waltham, MA 02453-2721

Call (781) 799-3949 Map

Fax (781) 899-6386

Mailing address

34 Wareham St, Apt. 1
Medford, MA 02155-6222

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X111824 (MA)

Mental Health Counselor: Definition to come...

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About NPI 1104907732

Mark A. Deyab, LICSW's National Provider Identifier is 1104907732, issued on Oct 18, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Waltham, MA. The record was last updated on Mar 17, 2009.