Provider Demographics
NPI:1477656254
Name:BRESSLER, RISA H (PHD)
Entity Type:Individual
Prefix:
First Name:RISA
Middle Name:H
Last Name:BRESSLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WALPOLE ST
Mailing Address - Street 2:STE 2
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3315
Mailing Address - Country:US
Mailing Address - Phone:508-543-2133
Mailing Address - Fax:508-543-0508
Practice Address - Street 1:1 WALPOLE ST
Practice Address - Street 2:STE 2
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3315
Practice Address - Country:US
Practice Address - Phone:508-543-2133
Practice Address - Fax:508-543-0508
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5088103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50408Medicare ID - Type Unspecified