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1104907732
MARK A DEYAB
WALTHAM, MA
NPI
1104907732
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: MA 111824)
Enumeration Date
2006-10-18
Last Update Date
2009-03-17
Business Address
MARK A DEYAB LICSW
20 HOPE AVE G-05
WALTHAM, MA 02453-2721
Phone number: 781-799-3949
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Mailing Address
MARK A DEYAB LICSW
34 WAREHAM ST APT. 1
MEDFORD, MA 02155-6222
Phone number: 781-799-3949
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