Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 102L00000X | Psychologist | 10979 | MA |
Y | 103T00000X | Psychologist | 10979 | MA |
NPI | 1003217845 |
---|---|
Provider Name | Dr. Lauren Persing |
First Address | Newton, MA 02459-3226 |
Second Address | Newton, MA 02459-3226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2014 |
Last Update Date | 28/08/2019 |