| Organization Name: | MARVISTA PSYCHOLOGICAL ASSOCIATE, P.C. |
| NPI Number: | 1639201544 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES F MUNDHENK (PRESIDENT) |
| Mailing Address: | 12 Parkingway Cohasset |
| State: | MA US |
| Postal Code: | 020251708 |
| Phone Number: | 7813830860 |
| Fax Number: | 7813831239 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |