Doctor Name: | DR. LYDIA YOUNG-JIN CHO |
NPI Number: | 1053756106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 9254 |
Business Practice Address: | 115 Mill St Mail Stop 234 Belmont, MA - 024781064 |
Business Phone Number: | 6178553506 |
Business Fax Number: | |
Mailing Address: | 115 Mill St, Mail Stop 234 BELMONT |
State: | MA |
Postal Code: | 024781064 |
Phone Number: | 6178553506 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2013 |
NPI Last Update Date: | 05/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 9254 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |