Provider Demographics
NPI:1952494197
Name:SILBERBOGEN, AMY KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KATHERINE
Last Name:SILBERBOGEN
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 1:150 SOUTH HUNTINGTON AVENUE
Mailing Address - Street 2:PSYCHOLOGY SERVICE (116B)
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:857-364-4707
Mailing Address - Fax:
Practice Address - Street 1:150 SOUTH HUNTINGTON AVENUE
Practice Address - Street 2:PSYCHOLOGY SERVICE (116B)
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:857-364-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8287103TC0700X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily