Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003059254 |
---|---|
Provider Name | Laurel T Ashcraft |
First Address | Woburn, MA 01801-6503 |
Second Address | Billerica, MA 01821-3776 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2009 |
Last Update Date | 27/11/2012 |