Provider Demographics
NPI:1629885488
Name:HANG BASSIONY, LISA CHING
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHING
Last Name:HANG BASSIONY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KERWIN ST # 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02124-1703
Mailing Address - Country:US
Mailing Address - Phone:617-595-1650
Mailing Address - Fax:
Practice Address - Street 1:1 KERWIN ST # 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-1703
Practice Address - Country:US
Practice Address - Phone:617-595-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst