Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 6419 | MA |
NPI | 1003080631 |
---|---|
Provider Name | Lori Schwartz |
First Address | Brighton, MA 02135 |
Second Address | Brighton, MA 02135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 04/08/2014 |