Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 3378 | MA |
NPI | 1346640109 |
---|---|
Provider Name | Lauren Pastori |
First Address | Cambridge, MA 02139-1047 |
Second Address | Cambridge, MA 02139-1047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2014 |
Last Update Date | 29/08/2014 |