Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 7454MA | MA |
Y | 103TC0700X | Clinical Psychologist | 7454MA | MA |
NPI | 1003850330 |
---|---|
Provider Name | Dr. Amaro J Laria |
First Address | Brookline, MA 02446-5587 |
Second Address | Brookline, MA 02446-5587 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |