Provider Demographics
NPI:1639898885
Name:ALIZA C YARROW PSYD LLC
Entity Type:Organization
Organization Name:ALIZA C YARROW PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIZA
Authorized Official - Middle Name:C
Authorized Official - Last Name:YARROW
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-209-7979
Mailing Address - Street 1:54 GREGORY ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-2106
Mailing Address - Country:US
Mailing Address - Phone:617-209-7979
Mailing Address - Fax:781-755-8009
Practice Address - Street 1:54 GREGORY ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-2106
Practice Address - Country:US
Practice Address - Phone:617-209-7979
Practice Address - Fax:781-755-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health