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DR. JUSTIN LEO ENGGASSER PH.D.

Behavioral Health & Social Service Providers Psychologist Addiction (Substance Use Disorder)

Provider NPI: 1730370032

Provider Information:
DR. JUSTIN LEO ENGGASSER PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
150 S. HUNTINGTON AVENUE VA BOSTON HEALTHCARE SYSTEM (116B) BOSTON, MA 02130 US
Tel: 774-826-1380  Fax: --

Business Mailing Address:
150 S. HUNTINGTON AVENUE VA BOSTON HEALTHCARE SYSTEM (116B) BOSTON, MA 02130 US
Tel: 774-826-1380  Fax: --

NPI Information:
NPI: 1730370032
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TA0400XBehavioral Health & Social Service Providers
Psychologist
Addiction (Substance Use Disorder)
MA8807
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
MA8807
N103TB0200XBehavioral Health & Social Service Providers
Psychologist
MA8807

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 103TC0700X

Type:

Classification:



Definition:



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