Provider Demographics
NPI:1790066322
Name:UBIEM, CYRIL SUNDAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:SUNDAY
Last Name:UBIEM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:31 HEATH ST
Mailing Address - Street 2:3 FLOOR
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-1650
Mailing Address - Country:US
Mailing Address - Phone:617-412-1794
Mailing Address - Fax:617-238-2431
Practice Address - Street 1:31 HEATH ST
Practice Address - Street 2:3 FLOOR
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-1650
Practice Address - Country:US
Practice Address - Phone:617-412-1794
Practice Address - Fax:617-238-2431
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling