Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | MA |
NPI | 1093213712 |
---|---|
Provider Name | Doug Lay |
First Address | Haverhill, MA 01835-8515 |
Second Address | Haverhill, MA 01835-8515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2018 |
Last Update Date | 28/01/2018 |