| Doctor Name: | DR. PHYLLIS KAY JOACHIM |
| NPI Number: | 1164644118 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 2994 |
| Business Practice Address: | 350 Washington Street Wellesley Hills, MA - 024816211 |
| Business Phone Number: | 7818485674 |
| Business Fax Number: | 7812358664 |
| Mailing Address: | 43 Palmer Road, WABAN |
| State: | MA |
| Postal Code: | 024681808 |
| Phone Number: | 7818485674 |
| Fax Number: | 7812358664 |
| NPI Enumeration Date: | 05/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2994 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |