Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1134622822 |
---|---|
Provider Name | Laura Louise Smith |
First Address | Waltham, MA 02453-3842 |
Second Address | Dracut, MA 01826-3311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 09/03/2018 |