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1013231604
MARC KONICOV
WAKEFIELD, MA
NPI
1013231604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: MA 4279)
Enumeration Date
2010-03-25
Last Update Date
2010-03-25
Business Address
Mr. MARC KONICOV LMHC
16 GREEN ST
WAKEFIELD, MA 01880-3730
Phone number: 781-245-1721
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Mailing Address
Mr. MARC KONICOV LMHC
16 GREEN ST
WAKEFIELD, MA 01880-3730
Phone number: 781-245-1721
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