Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 10482 | MA |
Y | 103TC0700X | Clinical Psychologist | 10482 | MA |
NPI | 1003236233 |
---|---|
Provider Name | Dr. Laura Richardson |
First Address | Boston, MA 02114-2621 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2014 |
Last Update Date | 24/03/2017 |