Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 11301 | MA |
Y | 103TC0700X | Clinical Psychologist | 11301 | MA |
N | 103TH0100X | Health Service | 57298 | MA |
NPI | 1235755398 |
---|---|
Provider Name | Dr. Jessica L Lazar Schwartz |
First Address | Belmont, MA 02478-1064 |
Second Address | Belmont, MA 02478-1064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 03/08/2020 |