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1710292990
ALLISTON DACOSTA THOMAS
ALLSTON, MA
NPI
1710292990
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-08-12
Last Update Date
2010-08-12
Business Address
-- ALLISTON DACOSTA THOMAS
14 FORDHAM RD
ALLSTON, MA 02134-3006
Phone number: 617-782-6460
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Mailing Address
-- ALLISTON DACOSTA THOMAS
61 COURT ST
MEDFORD, MA 02155-2669
Phone number: 617-820-7345
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