Diana Agatha Arezzo, PH.D.
Individual provider Active NPI Psychologist · Arlington, MA
NPI 1184100679 · NPPES record last updated Jul 17, 2018
Key facts
- NPI
- 1184100679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 2309-PY-PR (MA)
- Practice address
- 17 Revere St
Arlington, MA 02476-6128 - Phone
- (161) 720-1908
- NPI assigned
- Jul 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2309-PY-PR | MA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2309-PY-PR | MA | Yes |
Addresses
Primary practice location
17 Revere St
Arlington, MA 02476-6128
Mailing address
17 Revere St
Arlington, MA 02476-6128
Phone (161) 720-1908
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All providers in Arlington, MA · Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.