Doctor Name: | DR. CAMILLE M DIBENEDETTO |
NPI Number: | 1013028604 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 6087 |
Business Practice Address: | 49 Hancock St Suite 205 Cambridge, MA - 02139 |
Business Phone Number: | 6174928775 |
Business Fax Number: | 6179241027 |
Mailing Address: | Po Box 391288, CAMBRIDGE |
State: | MA |
Postal Code: | 02139 |
Phone Number: | 6174928775 |
Fax Number: | 6179241027 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6087 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |