Provider Demographics
NPI:1194811448
Name:WAHBA, DANIELLE ANDREA (MA, PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ANDREA
Last Name:WAHBA
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Gender:F
Credentials:MA, PSYD
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Mailing Address - Street 1:354 W BOYLSTON ST STE 224
Mailing Address - Street 2:FAMILY WORKS PSYCHOLOGICAL AND ASSESSMENT SERVICES, LLC
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-2373
Mailing Address - Country:US
Mailing Address - Phone:508-791-1454
Mailing Address - Fax:508-791-3318
Practice Address - Street 1:354 W BOYLSTON ST
Practice Address - Street 2:SUITE 224
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-2373
Practice Address - Country:US
Practice Address - Phone:508-791-1454
Practice Address - Fax:508-791-3318
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2015-12-07
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Provider Licenses
StateLicense IDTaxonomies
MA8302103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW51408Medicare UPIN
MAW06398OtherBCBS/MAGELLAN
MAW51408Medicare UPIN