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1104993518
THALIA VITIKOS
WALTHAM, MA
NPI
1104993518
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: MA 805)
Enumeration Date
2006-11-29
Last Update Date
2011-01-31
Business Address
THALIA VITIKOS LMHC
675 MAIN ST REAR
WALTHAM, MA 02453-6354
Phone number: 339-206-4477
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Mailing Address
THALIA VITIKOS LMHC
180C RIVER ST APT 9
WALTHAM, MA 02453-6567
Phone number: 781-647-5674
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