Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 4746 | MA |
Y | 103T00000X | Psychologist | 4746 | MA |
NPI | 1013925825 |
---|---|
Provider Name | Dr. Elaine Garcia Leclair |
First Address | Boston, MA 02115-5724 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 27/05/2009 |