Provider Demographics
NPI:1376745190
Name:FRIEDMAN-YAKOOBIAN, MICHELLE S (PHD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:FRIEDMAN-YAKOOBIAN
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:75 FENWOOD RD
Mailing Address - Street 2:MASSACHUSETTS MENTAL HEALTH CTR 5TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6103
Mailing Address - Country:US
Mailing Address - Phone:617-754-1210
Mailing Address - Fax:617-754-1250
Practice Address - Street 1:75 FENWOOD RD
Practice Address - Street 2:MASSACHUSETTS MENTAL HEALTH CTR 5TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6103
Practice Address - Country:US
Practice Address - Phone:617-754-1210
Practice Address - Fax:617-754-1250
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2013-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA8634103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical