Deville, Douglas M.

Deville, Douglas M. is an sole proprietor health care provider with primary practice located at 729 Boylston St 4Th Floor, Boston MA 02116-2639. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Deville, Douglas M. can be contacted via phone (617) 262-7771.

Contact Information

Primary practice address
729 Boylston St 4Th Floor Boston MA 02116-2639
Phone: (617) 262-7771
Fax: (617) 262-7790
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6011 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 600 New Hampshire

Profile Details

NPI number 1902882731
LBN Legal business name Deville, Douglas M.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902882731 NPPES
Massachusetts MEDICAID DEW04804
Massachusetts MEDICAID 80001996

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